Anomalies of the Left Ventricular Outflow Tract and Aortic Valve

Simpson, John; Miller, Owen

doi:10.1002/9781119612858.ch20

Cited by 2 publications

(2 citation statements)

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“…Congenital aortic valve stenosis was defined as an inborn abnormality of the aortic valve with a flow velocity of at least 3 m/second across it and/or significantly decreased aortic valve area on echocardiography. [14][15][16][17] Medical history, demographic, and anthropometric characteristics were obtained on admission. Standard two-dimensional and Doppler transthoracic echocardiography with assessment of the aortic valve anatomy and hemodynamics, as well as left ventricular systolic function (assessed by left ventricular shortening fraction), was performed the day before and the day after the balloon aortic valvuloplasty, as well as at regular check-ups in the follow-up.…”

Section: Baseline Clinical Assessmentmentioning

confidence: 99%

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Immediate results of primary balloon dilation for congenital aortic valve stenosis predict the mid-term outcome

et al. 2023

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Background: Balloon valvuloplasty is the primary treatment for congenital aortic valve stenosis in our centre. We sought to determine independent predictors of reintervention (surgical repair or repeated balloon dilation) after primary valvuloplasty. Methods: We retrospectively studied patients with congenital aortic valve stenosis who underwent balloon valvuloplasty during 2004–2018. The following risk factors were analysed: aortic valve insufficiency after balloon valvuloplasty >+1/4, post-procedural gradient across the aortic valve ≥35 mmHg, pre-interventional gradient across the valve, annulus size, use of rapid pacing, and balloon/annulus ratio. Primary outcome was aortic valve reintervention. Results: In total, 99 patients (median age 4 years, range 1 day to 26 years) underwent balloon valvuloplasty for congenital aortic valve stenosis. After a mean follow-up of 4.0 years, 30% had reintervention. Adjusted risks for reintervention were significantly increased in patients with post-procedural aortic insufficiency grade >+1/4 and/or residual gradient ≥35 mmHg (HR 2.55, 95% CI 1.13–5.75, p = 0.024). Pre-interventional gradient, annulus size, rapid pacing, and balloon/annulus ratio were not associated with outcome. Conclusion: Post-procedural aortic valve insufficiency grade >+1/4 and/or residual gradient ≥35 mmHg in patients undergoing balloon valvuloplasty for congenital aortic valve stenosis confers an increased risk for reintervention in mid-term follow-up.

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Section: Baseline Clinical Assessmentmentioning

confidence: 99%

“…Morphometric analysis of the aortic valve and the aortic valve annulus has been conducted in the parasternal long-and short-axis view. 14,16 The peak end-systolic gradient between the left ventricle and the aorta was obtained using continuous wave Doppler.…”

Section: Baseline Clinical Assessmentmentioning

confidence: 99%