Twenty-Five Year Experience With Balloon Aortic Valvuloplasty for Congenital Aortic Stenosis

Balloon aortic valvuloplasty (BAV) is the primary therapy for congenital aortic stenosis (AS). Few reports describe long-term outcomes. In this study, a retrospective single-institution review was performed of patients who underwent BAV for congenital AS. The following end points were evaluated: mod...

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Bibliographic Details
Published in:The American journal of cardiology 2011-10, Vol.108 (7), p.1024-1028
Main Authors: Maskatia, Shiraz A., MD, Ing, Frank F., MD, Justino, Henri, MD, Crystal, Matthew A., MD, Mullins, Charles E., MD, Mattamal, Raphael J., BS, O'Brian Smith, E., PhD, Petit, Christopher J., MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aortic Valve
Aortic Valve Stenosis - congenital
Aortic Valve Stenosis - mortality
Aortic Valve Stenosis - therapy
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Cardiovascular disease
Catheterization - methods
Child
Child, Preschool
Clinical outcomes
Congenital diseases
Endocardial and cardiac valvular diseases
Female
Follow-Up Studies
Heart
Heart surgery
Humans
Infant
Infant, Newborn
Male
Medical sciences
Retrospective Studies
Survival Rate - trends
Texas - epidemiology
Time Factors
Treatment Outcome
Young Adult
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Summary:Balloon aortic valvuloplasty (BAV) is the primary therapy for congenital aortic stenosis (AS). Few reports describe long-term outcomes. In this study, a retrospective single-institution review was performed of patients who underwent BAV for congenital AS. The following end points were evaluated: moderate or severe aortic insufficiency (AI) by echocardiography, aortic valve replacement, repeat BAV, surgical aortic valvotomy, and transplantation or death. From 1985 to 2009, 272 patients who underwent BAV at ages 1 day to 30.5 years were followed for 5.8 ± 6.7 years. Transplantation or death occurred in 24 patients (9%) and was associated with depressed baseline left ventricular shortening fraction (LVSF) (p = 0.04). Aortic valve replacement occurred in 42 patients (15%) at a median of 3.5 years (interquartile range 75 days to 5.9 years) after BAV and was associated with post-BAV gradient ≥25 mm Hg (p = 0.02), the presence of post-BAV AI (p = 0.03), and below-average baseline LVSF (p = 0.04). AI was found in 83 patients (31%) at a median of 4.8 years (interquartile range 1.4 to 8.7) and was inversely related to post-BAV gradient ≥25 mm Hg (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2011.05.040