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Long-Term Results of Balloon Valvuloplasty as Primary Treatment for Congenital Aortic Valve Stenosis: a 20-Year Review

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Soulatges , Camille [UCL] Momeni, Mona [UCL] Zarrouk, Nadia [UCL] Moniotte, Stéphane [UCL] Carbonez, Karlien [UCL] Barréa, Catherine [UCL] Rubay, Jean [UCL] Poncelet, Alain [UCL] Sluysmans, Thierry [UCL]

In the presence of new surgical techniques, the treatment of congenital valvular aortic stenosis is under debate. We reviewed the results and late outcomes of all 93 patients aged 1 day to 18 years, treated with balloon valvuloplasty (BAV) as first-line therapy for congenital aortic valve stenosis in our center from January 1991 to May 2012. Mean age at procedure time was 2.4 years; 37 patients underwent BAV at age ≤30 days (neonates), 29 patients at age ≥1 month and <1 year (infants), and 27 patients were older than 1 year (children). The invasive BAV peak-to-peak aortic valve gradient (mean 59 ± 22 mmHg) was immediately reduced (mean 24 ± 12 mmHg). The observed diminution of gradient was similar for each age group. Four patients had significant post-BAV AI. Mean follow-up after BAV was 11.4 ± 7 years. The last echo peak aortic gradient was 37 ± 18 mmHg and mean gradient was 23 ± 10 mmHg, and two patients had significant AI. Actuarial survival for the whole cohort was 88.2 and 72.9 % for the neonates. All infants, except one, and all children survived. Sixty-six percent of patients were free from surgery, and 58 % were free from any reintervention, with no difference according to age. Freedom from surgery after BAV at 5, 10, and 20 years, respectively, was 82, 72, and 66 %. Our study confirms that BAV as primary treatment for congenital AS is an efficient and low-risk procedure in infants and children. In neonates, the prognosis is more severe and clearly related to "borderline LV."

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2015
Language Anglais
Journal information "Pediatric Cardiology" - Vol. 36, no. 6, p. 1145-1152 (2015)
Peer reviewed yes
Publisher Springer New York LLC ((United States) New York, NY)
issn 0172-0643
e-issn 1432-1971
Publication status Publié
Affiliations UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire
UCL - SSS/IREC/PEDI - Pôle de Pédiatrie
UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique
UCL - (SLuc) Service de cardiologie pédiatrique
UCL - (SLuc) Service d'anesthésiologie
UCL - (SLuc) Centre des cardiopathies congénitales de l'adulte
Keywords Congenital valvular aortic stenosis ; Balloon valvuloplasty ; Outcome ; Shone’s syndrome
Links
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Bibliographic reference Soulatges , Camille ; Momeni, Mona ; Zarrouk, Nadia ; Moniotte, Stéphane ; Carbonez, Karlien ; et. al. Long-Term Results of Balloon Valvuloplasty as Primary Treatment for Congenital Aortic Valve Stenosis: a 20-Year Review. In: Pediatric Cardiology, Vol. 36, no. 6, p. 1145-1152 (2015)
Permanent URL http://hdl.handle.net/2078.1/161208