Balloon Dilation and Surgical Valvotomy Comparison in Non-critical Congenital Aortic Valve Stenosis

Abstract

Percutaneous balloon aortic valvoplasty (BAV) and surgical aortic valvotomy (SAV) are palliative procedures in patients with non-critical congenital valve stenosis. The aim of the study was to evaluate long-term BAV and SAV results after up to 24 years of follow-up. From 1987 to 2013, 74 consecutive interventions were performed in patients with aortic stenosis, and 62 were included in the study (39 BAVs and 23 SAVs). Age of BAV patients was 1.3 months to 17 years, and of SAV patients 1.2 months to 15 years. Although BAV patients were older, there was no difference between groups according to sex, valve function/morphology, and early/late follow-up results, with exception to hospitalization period. Significant pressure gradient reduction and aortic regurgitation increment were registered after procedures. Three patients did not survive early period after surgery. Follow-up period was 7.0 ± 5.4 and 9.0 ± 8.0 years after BAV and SAV, respectively (p = 0.242). Follow-up pressure gradient rose only in the BAV group, and was emphasized after 10-year-follow-up (p = 0.020). Significant aortic insufficiency progression was registered after 15 years of follow-up in both groups (p = 0.007 and p = 0.009, respectively). Mean reintervention-free survival was 12.0 years in the BAV and 14.5 years in the SAV group (p = 0.733), and mean survival without aortic valve replacement was 15.2 and 17.4 years, respectively (p = 0.877). BAV and SAV in patients with congenital aortic stenosis are very comparable in both early and late follow-up results.

The Use of Continuous Electrocardiographic Holter Monitoring in Pediatric Cardiology

“…After operative correction of congenital heart anomalies, the most common postoperative arrhythmias are right bundle branch block, atrioventricular block second degree (Mobitz type 2), atrioventricular block grade III, left bundle branch block, paroxysmal supraventricular tachycardia, and in older children atrial fibrillation ( 9 ). The hardest dysrhythmia occur after replacing the valve, and in the postoperative valvular anomalies incidence of postoperative complete block is 60-80% with thrombosis, hypovolemia and dehydration especially in young children ( 10 ). Considering that congenital heart defects have evolving character, their early diagnosis is imperative, and complete objectification due to the complex anatomy and hemodynamics, association with other anomalies have crucial importance for the pediatric cardiac surgeon.…”

Surgical Valvotomy Versus Balloon Valvuloplasty for Congenital Aortic Valve Stenosis: A Systematic Review and Meta‐Analysis

“…When multiple studies were reported from the same institution with potentially overlapping patients, the most recent study was used. After application of the inclusion/exclusion criteria, 20 studies were eligible for the meta‐analysis (Figure ) . Two database studies were included that may have overlapping patients with other single‐center reports …”

Surgical and Transcatheter Treatments in Children with Congenital Aortic Stenosis

“…Both procedures were associated with low early and late mortalities. [3][4][5][6][7][8][9][10][11][12][13][14][15] With exclusion of LV hypoplasia, the overall mortality dropped to $4% at our center. Most of the early deaths had a poor clinical course with significantly dilated LV.…”