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

• Published in: Pediatric cardiology 2015-03, Vol.36 (3), p.616-624
• Main Authors: Prijic, Sergej M., Vukomanovic, Vladislav A., Stajevic, Mila S., Bjelakovic, Bojko B., Zdravkovic, Marija D., Sehic, Igor N., Kosutic, Jovan Lj
• Format: Article
• Language: English
• Subjects: Adolescent; Analysis; Aortic Valve - surgery; Aortic Valve Insufficiency - etiology; Aortic Valve Insufficiency - physiopathology; Aortic Valve Insufficiency - surgery; Aortic valve stenosis; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - congenital; Aortic Valve Stenosis - physiopathology; Aortic Valve Stenosis - surgery; Balloon Valvuloplasty - methods; Cardiac Surgery; Cardiac Surgical Procedures - methods; Cardiology; Catheterization - methods; Child; Child, Preschool; Follow-Up Studies; Genetic disorders; Humans; Infant; Medicine; Medicine & Public Health; Original Article; Reoperation - statistics & numerical data; Survival Rate; Time Factors; Treatment Outcome; Vascular Surgery
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-014-1056-6

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.