Abstract
Objective: To evaluate immediate and midterm results after balloon
valvuloplasty in an infant population with critical aortic stenosis, giving
special consideration to relief of aortic stenosis, degree of aortic
regurgitation (AR), left ventricular function, and duration of freedom from
reintervention.
Method: A retrospective follow up study was performed in 25 neonates
who underwent aortic valve balloon dilatation from July 2006 to July
2010. We assessed the clinical and echocardiographic outcome for
degree of restenosis, LV function, AR and need for reintervension.
Result: The median age at dilatation was 45 days (range from 6 days –
120 days). The median weight was 3.9 kg (1.9 kg-6.4kg). The balloon
valvuloplasty was performed with manual inflation of balloon through the
femoral artery. The mean systolic pressure gradient across the aortic
valve decreased from 70 ± 7.23 mmHg to 40 mmHg ± 4.3 (p=0.001). Mild
aortic regurgitation developed in 12 patients while in one patient noncoronary cusp was perforated, leading to severe AR, needing surgery.
There was one death during the procedure.
At mean follow up of 25 months (3.0 - 48 months), there was no
progression of AR. No patient had needed re-intervention for re-stenosis.
LV function improved in 9 out of11 patients (82%) while there was one
death 2 months post procedure due to persistent LV dysfunction.
Conclusion: Balloon valvuloplasty in infants with critical AS is a safe and
effective therapeutic procedure. The mortality is 8%. Mild aortic
regurgitation does not progress in short and intermediate term. There is
no restenosis in intermediate term and LV function improves in majority of
the patients
