Successful balloon valvuloplasty for neonatal critical aortic stenosis

Lababidi, Zuhdi; Weinhaus, Larry

doi:10.1016/0002-8703(86)90299-1

Cited by 78 publications

(21 citation statements)

References 11 publications

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“…By valvoplasty, the catheter measured gradient was reduced from a mean (SD) of 78. 3 2). Figure 3 shows details of the clinical outcome.…”

Section: Resultsmentioning

confidence: 99%

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Long term results of percutaneous balloon valvoplasty of congenital aortic stenosis: independent predictors of outcome

Reich

Tax²,

Marek³

et al. 2004

Heart

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Objective: To evaluate long term results and independent predictors of outcome of aortic valvoplasty. Design: Retrospective follow up study. Independent predictors of outcome identified by multiple logistic regression. Setting: Tertiary referral centre. Patients: 269 consecutive patients treated at the median age of 8 months (0-23 years): 80 (30%) under 4 weeks, 59 (22%) between 4 weeks and 1 year, and 130 (48%) over 1 year. The follow up period was up to 14.8 years (median 5.3, in survivors 6.4 years). Interventions: Percutaneous balloon valvoplasty with mean (SD) balloon to annulus ratio 0.97 (0.08). Main outcome measures: Restenosis > 70 mm Hg, grade 3 aortic insufficiency, cusps disruption, surgery, death, and valvoplasty failure (significant restenosis or insufficiency or surgery or death). Results: The mortality rate was 10.4% (n = 28), the restenosis rate was 16.7% (n = 45), significant insufficiency developed in 22.3% (n = 60), surgery was needed in 20.1% (n = 54), and ''valvoplasty failure'' occurred in 41.6% (n = 112) patients. Mean (SEM) survival probability 14.4 years after the procedure was 0.89 (0.02) and mean (SEM) probability of surgery-free survival was 0.50 (0.08). The independent predictors were as follows. For restenosis: small aortic annulus; for cusp disruption: large aortic annulus; for insufficiency: bicuspid aortic valve; for need for surgery: bicuspid aortic valve; for death: small aortic annulus, low left ventricular shortening fraction, and low sequential number of the valvoplasty; and for valvoplasty failure: small aortic annulus, bicuspid aortic valve, and high grade of mitral insufficiency. Conclusion: Independent predictors of unfavourable outcome are small aortic annulus, bicuspid aortic valve, poor function of left ventricle or mitral valve, and limited operator experience. P ercutaneous balloon valvoplasty was first described in 1983.1 The effectiveness of the method in gradient reduction and the low incidence of restenosis shortly after the procedure were documented in children with congenital aortic stenosis. 2In 1986, the first balloon valvoplasty was performed in a newborn with critical aortic stenosis.3 Good short term results were obtained in a large cohort of children in a multicentre study. 4 Mid-term results, however, showed a substantial incidence of restenosis, severe aortic insufficiency, and reinterventions.5 6 Long term results have so far been published only for children treated after 1 year of age with a 20% restenosis rate and a 21% incidence of significant aortic insufficiency 2-12 years after the procedure.

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“…By valvoplasty, the catheter measured gradient was reduced from a mean (SD) of 78. 3 2). Figure 3 shows details of the clinical outcome.…”

Section: Resultsmentioning

confidence: 99%

“…2 In 1986, the first balloon valvoplasty was performed in a newborn with critical aortic stenosis. 3 Good short term results were obtained in a large cohort of children in a multicentre study. 4 Mid-term results, however, showed a substantial incidence of restenosis, severe aortic insufficiency, and reinterventions.…”

Section: Years)mentioning

confidence: 94%

Long term results of percutaneous balloon valvoplasty of congenital aortic stenosis: independent predictors of outcome

Reich

Tax²,

Marek³

et al. 2004

Heart

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show abstract

“…At this point, anterograde dilatation [11,12]of the aortic valve was contemplated. We did not attempt femoral venous access, but instead exchanged the umbilical venous catheter with a 5F sheath, with the sheath tip positioned in the lower right atrium.…”

Section: Case Reportmentioning

confidence: 99%

Transumbilical venous, anterograde, snare-assisted balloon aortic valvuloplasty in a neonate with critical aortic stenosis

Rao

Jureidini

1998

Cathet. Cardiovasc. Diagn.

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“…Treatment of heart failure in this circumstance requires optimizing hemodynamics until urgent intervention can occur. Balloon valvuloplasty, first described in neonates in 1986, 39 has all but replaced surgical valvotomy, as the first-line intervention in uncomplicated AS, including critical AS. Ventricular function improves and usually normalizes after catheterbased or surgical intervention.…”

Section: Congenital Heart Disease: Pressure Overloadmentioning

confidence: 99%