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Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis?
For neonates with critical aortic valve stenosis who are selected for biventricular repair, valvotomy can be achieved surgically (SAV) or by transcatheter balloon dilation (BAV). Data regarding 110 neonates with critical aortic valve stenosis were evaluated in a study by the Congenital Heart Surgeon...
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| Published in: | Circulation (New York, N.Y.) N.Y.), 2001-09, Vol.104 (12 Suppl 1), p.I152-I158 |
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| container_end_page | I158 |
| container_issue | 12 Suppl 1 |
| container_start_page | I152 |
| container_title | Circulation (New York, N.Y.) |
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| creator | McCrindle, B W Blackstone, E H Williams, W G Sittiwangkul, R Spray, T L Azakie, A Jonas, R A |
| description | For neonates with critical aortic valve stenosis who are selected for biventricular repair, valvotomy can be achieved surgically (SAV) or by transcatheter balloon dilation (BAV).
Data regarding 110 neonates with critical aortic valve stenosis were evaluated in a study by the Congenital Heart Surgeons Society from 1994 to 1999. Reduced left ventricular function was present in 46% of neonates. The initial procedure was SAV in 28 patients and BAV in 82 patients. Mean percent reduction in systolic gradient was significantly greater with BAV (65+/-17%) than SAV (41+/-32%; P |
| doi_str_mv | 10.1161/circ.104.suppl_1.I-152 |
| format | article |
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Data regarding 110 neonates with critical aortic valve stenosis were evaluated in a study by the Congenital Heart Surgeons Society from 1994 to 1999. Reduced left ventricular function was present in 46% of neonates. The initial procedure was SAV in 28 patients and BAV in 82 patients. Mean percent reduction in systolic gradient was significantly greater with BAV (65+/-17%) than SAV (41+/-32%; P<0.001). Higher residual median gradients were present in the SAV versus BAV group (36 mm Hg [range, 10 to 85 mm Hg] versus 20 mm Hg [0 to 85 mm Hg], P<0.001). Important aortic regurgitation was more often present after BAV (18%) than SAV (3%; P=0.07). Time-related survival after valvotomy was 82% at 1 month and 72% at 5 years, with no significant difference for SAV versus BAV, even after adjustment for differences in patient and disease characteristics. Independent risk factors for mortality were mechanical ventilation before valvotomy, smaller aortic valve annulus (z score), smaller aortic diameter at the sinotubular junction (z score), and a smaller subaortic region. A second procedure was performed in 46 survivors. Estimates for freedom from reintervention were 91% at 1 month and 48% at 5 years after the initial valvotomy and did not differ significantly between groups.
SAV and BAV for neonatal critical aortic stenosis have similar outcomes. There is a greater likelihood of important aortic regurgitation with BAV and of residual stenosis with SAV.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/circ.104.suppl_1.I-152</identifier><identifier>PMID: 11568048</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Acute Disease ; Aortic Valve Insufficiency - etiology ; Aortic Valve Stenosis - diagnosis ; Aortic Valve Stenosis - surgery ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - statistics & numerical data ; Catheterization - statistics & numerical data ; Demography ; Echocardiography ; Follow-Up Studies ; Humans ; Infant, Newborn ; Prospective Studies ; Reoperation - statistics & numerical data ; Risk Assessment ; Risk Factors ; Survival Analysis ; Survival Rate ; Treatment Outcome ; Videotape Recording</subject><ispartof>Circulation (New York, N.Y.), 2001-09, Vol.104 (12 Suppl 1), p.I152-I158</ispartof><rights>Copyright American Heart Association, Inc. Sep 18, 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c314t-330f38e5f0c154bc94fb515ae0a1a6dccba7d71278bf012dba94c2475e2f283b3</citedby><cites>FETCH-LOGICAL-c314t-330f38e5f0c154bc94fb515ae0a1a6dccba7d71278bf012dba94c2475e2f283b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11568048$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McCrindle, B W</creatorcontrib><creatorcontrib>Blackstone, E H</creatorcontrib><creatorcontrib>Williams, W G</creatorcontrib><creatorcontrib>Sittiwangkul, R</creatorcontrib><creatorcontrib>Spray, T L</creatorcontrib><creatorcontrib>Azakie, A</creatorcontrib><creatorcontrib>Jonas, R A</creatorcontrib><creatorcontrib>the members of the Congenital Heart Surgeons Society</creatorcontrib><title>Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis?</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>For neonates with critical aortic valve stenosis who are selected for biventricular repair, valvotomy can be achieved surgically (SAV) or by transcatheter balloon dilation (BAV).
Data regarding 110 neonates with critical aortic valve stenosis were evaluated in a study by the Congenital Heart Surgeons Society from 1994 to 1999. Reduced left ventricular function was present in 46% of neonates. The initial procedure was SAV in 28 patients and BAV in 82 patients. Mean percent reduction in systolic gradient was significantly greater with BAV (65+/-17%) than SAV (41+/-32%; P<0.001). Higher residual median gradients were present in the SAV versus BAV group (36 mm Hg [range, 10 to 85 mm Hg] versus 20 mm Hg [0 to 85 mm Hg], P<0.001). Important aortic regurgitation was more often present after BAV (18%) than SAV (3%; P=0.07). Time-related survival after valvotomy was 82% at 1 month and 72% at 5 years, with no significant difference for SAV versus BAV, even after adjustment for differences in patient and disease characteristics. Independent risk factors for mortality were mechanical ventilation before valvotomy, smaller aortic valve annulus (z score), smaller aortic diameter at the sinotubular junction (z score), and a smaller subaortic region. A second procedure was performed in 46 survivors. Estimates for freedom from reintervention were 91% at 1 month and 48% at 5 years after the initial valvotomy and did not differ significantly between groups.
SAV and BAV for neonatal critical aortic stenosis have similar outcomes. There is a greater likelihood of important aortic regurgitation with BAV and of residual stenosis with SAV.</description><subject>Acute Disease</subject><subject>Aortic Valve Insufficiency - etiology</subject><subject>Aortic Valve Stenosis - diagnosis</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - statistics & numerical data</subject><subject>Catheterization - statistics & numerical data</subject><subject>Demography</subject><subject>Echocardiography</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Prospective Studies</subject><subject>Reoperation - statistics & numerical data</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Videotape Recording</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNpdkUtrHDEQhEVwiNdO_oIROfg2a7Ue8zgZY5xkYSGX5Cw02p54zMxorJYW_O8j2wuBXLq7oKpo-Bi7ArEFqOHGj9FvQegt5XWdLGx3FRj5gW3K1JU2qjtjGyFEVzVKynN2QfRUZK0a84mdA5i6FbrdsPUuIg85-TAj8TBwyvHP6N3EjxgpE0_RLeRdesSEkfdumkJY-NFNx5DC_MLxOY9F4ZL4uPAFw-JSSfs4prcaF2I5OCVcAo10-5l9HNxE-OW0L9nvbw-_7n9U-5_fd_d3-8or0KlSSgyqRTMID0b3vtNDb8A4FA5cffC-d82hAdm0_SBAHnrXaS91Y1AOslW9umTX771rDM8ZKdl5JI_T5MqPmWwD0Had6Yrx63_Gp5DjUn6zsvTLTkJbTPW7ycdAFHGwaxxnF18sCPsKxL4CKULbExC7swVFCV6d2nM_4-Ff7ERA_QVvuI1K</recordid><startdate>20010918</startdate><enddate>20010918</enddate><creator>McCrindle, B W</creator><creator>Blackstone, E H</creator><creator>Williams, W G</creator><creator>Sittiwangkul, R</creator><creator>Spray, T L</creator><creator>Azakie, A</creator><creator>Jonas, R A</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20010918</creationdate><title>Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis?</title><author>McCrindle, B W ; Blackstone, E H ; Williams, W G ; Sittiwangkul, R ; Spray, T L ; Azakie, A ; Jonas, R A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c314t-330f38e5f0c154bc94fb515ae0a1a6dccba7d71278bf012dba94c2475e2f283b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Acute Disease</topic><topic>Aortic Valve Insufficiency - etiology</topic><topic>Aortic Valve Stenosis - diagnosis</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - statistics & numerical data</topic><topic>Catheterization - statistics & numerical data</topic><topic>Demography</topic><topic>Echocardiography</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Prospective Studies</topic><topic>Reoperation - statistics & numerical data</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Videotape Recording</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McCrindle, B W</creatorcontrib><creatorcontrib>Blackstone, E H</creatorcontrib><creatorcontrib>Williams, W G</creatorcontrib><creatorcontrib>Sittiwangkul, R</creatorcontrib><creatorcontrib>Spray, T L</creatorcontrib><creatorcontrib>Azakie, A</creatorcontrib><creatorcontrib>Jonas, R A</creatorcontrib><creatorcontrib>the members of the Congenital Heart Surgeons Society</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McCrindle, B W</au><au>Blackstone, E H</au><au>Williams, W G</au><au>Sittiwangkul, R</au><au>Spray, T L</au><au>Azakie, A</au><au>Jonas, R A</au><aucorp>the members of the Congenital Heart Surgeons Society</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis?</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2001-09-18</date><risdate>2001</risdate><volume>104</volume><issue>12 Suppl 1</issue><spage>I152</spage><epage>I158</epage><pages>I152-I158</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>For neonates with critical aortic valve stenosis who are selected for biventricular repair, valvotomy can be achieved surgically (SAV) or by transcatheter balloon dilation (BAV).
Data regarding 110 neonates with critical aortic valve stenosis were evaluated in a study by the Congenital Heart Surgeons Society from 1994 to 1999. Reduced left ventricular function was present in 46% of neonates. The initial procedure was SAV in 28 patients and BAV in 82 patients. Mean percent reduction in systolic gradient was significantly greater with BAV (65+/-17%) than SAV (41+/-32%; P<0.001). Higher residual median gradients were present in the SAV versus BAV group (36 mm Hg [range, 10 to 85 mm Hg] versus 20 mm Hg [0 to 85 mm Hg], P<0.001). Important aortic regurgitation was more often present after BAV (18%) than SAV (3%; P=0.07). Time-related survival after valvotomy was 82% at 1 month and 72% at 5 years, with no significant difference for SAV versus BAV, even after adjustment for differences in patient and disease characteristics. Independent risk factors for mortality were mechanical ventilation before valvotomy, smaller aortic valve annulus (z score), smaller aortic diameter at the sinotubular junction (z score), and a smaller subaortic region. A second procedure was performed in 46 survivors. Estimates for freedom from reintervention were 91% at 1 month and 48% at 5 years after the initial valvotomy and did not differ significantly between groups.
SAV and BAV for neonatal critical aortic stenosis have similar outcomes. There is a greater likelihood of important aortic regurgitation with BAV and of residual stenosis with SAV.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>11568048</pmid><doi>10.1161/circ.104.suppl_1.I-152</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2001-09, Vol.104 (12 Suppl 1), p.I152-I158 |
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| language | eng |
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| source | Free E-Journal (出版社公開部分のみ） |
| subjects | Acute Disease Aortic Valve Insufficiency - etiology Aortic Valve Stenosis - diagnosis Aortic Valve Stenosis - surgery Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - statistics & numerical data Catheterization - statistics & numerical data Demography Echocardiography Follow-Up Studies Humans Infant, Newborn Prospective Studies Reoperation - statistics & numerical data Risk Assessment Risk Factors Survival Analysis Survival Rate Treatment Outcome Videotape Recording |
| title | Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis? |
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