Percutaneous Balloon Aortic Valvuloplasty in Infancy and Childhood

Rupprath, G; Neuhaus, K.-L.

doi:10.1007/978-1-4613-8598-1_84

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…Discussion PBAV was originally described as treatment for congenital valvar AS in children. [1][2][3][4][5] The excellent early outcome in this population led to application of the procedure in elderly patients with calcific AS. Due to the large patient population available, all systematic follow-up studies evaluating the late effectiveness of PBAV have been in the elderly population.…”

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confidence: 99%

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Intermediate-term effectiveness of balloon valvuloplasty for congenital aortic stenosis. A prospective follow-up study.

et al. 1991

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BACKGROUND Percutaneous balloon valvuloplasty has proven to be acutely effective in the treatment of congenital valvar aortic stenosis; however, the intermediate- and long-term effectiveness of the procedure remain to be documented. METHODS AND RESULTS To assess the intermediate-term effectiveness of balloon valvuloplasty, repeat catheterization was performed in 27 of 30 children 1.7 +/- 0.1 years after balloon valvuloplasty for congenital aortic stenosis (AS). In 33 children the peak AS gradient was reduced acutely by 55% from 77 +/- 4 to 35 +/- 3 mm Hg (p less than 0.001), and left ventricular systolic pressure was reduced from 176 +/- 4 to 138 +/- 4 mm Hg (p less than 0.001). Despite a technically adequate valvuloplasty procedure, three patients had inadequate relief of obstruction and required complex surgical intervention. Twenty-seven of the 30 patients available for late reevaluation (90%) enrolled in the follow-up study. The peak AS gradient remained significantly reduced compared with that present before valvuloplasty (29 +/- 3 versus 77 +/- 4 mm Hg, p less than 0.001). Furthermore, there was no difference in peak AS gradient at follow-up compared with that immediately after valvuloplasty. The greatest increase in gradient at reevaluation was 14 mm Hg. Twenty of 27 patients (74%) had no change in the degree of aortic insufficiency at follow-up compared with that present before valvuloplasty. At follow-up, 16 patients had no aortic insufficiency at all, and only two had moderate-to-severe (3-4+) insufficiency. Femoral artery injury was documented in four patients, three of whom were under 12 months of age at valvuloplasty. CONCLUSIONS Balloon aortic valvuloplasty provides safe and effective intermediate-term gradient relief without early restenosis in children and adolescents with congenital AS.

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“…[1][2][3][4][5]19,20 As follow-up studies, however, these reports are incomplete because they have presented late hemodynamic data in only a minority of their patients. Vogel and colleagues, for example, provided intermediate-term hemodynamic data on nine of 25 children after PBAV.…”

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Intermediate-term effectiveness of balloon valvuloplasty for congenital aortic stenosis. A prospective follow-up study.

et al. 1991

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“…Percutaneous balloon dilatation of congenital valvular aortic stenosis is now an acceptable mode of treatment [1][2][3]. Balloon dilatation of aortic valve, however, is often associated with problems of balloon seating across the valve and slippage during performance of dilatation.…”

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confidence: 99%