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Percutaneous aortic valvoplasty in congenital aortic valvar stenosis

Published online by Cambridge University Press:  30 July 2009

Carlos Alva ,
Agusím Sánchez ,
Felipe David ,
Santiago Jiménez ,
David Jiménez ,
José Ortegón ,
Martha Hernández ,
José Antonio Magaña ,
Rubén Argüero  and
Mariano Ledesma
Carlos Alva*
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
Agusím Sánchez
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
Felipe David
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
Santiago Jiménez
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
David Jiménez
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
José Ortegón
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
Martha Hernández
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
José Antonio Magaña
Affiliation:
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
Rubén Argüero
Affiliation:
Director, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
Mariano Ledesma
Affiliation:
Interventionist, Cardiology Department, Hospital de Cardiología, National Medical Centre Siglo, XXI, Mexico City, Mexico
*
Servicio de Cardiopatías Congénitas, Hospital de Cardiología, National Medical Centre Siglo, XXI, Av. Cuauhtemoc 330, Col. Doctores, Mexico City, Distrito Federal, CP 06721. Tel: 52 5627 6900 ext. 2500; Fax: 52 5761 4867; E-mail: alval@prodigy.net.mx
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Abstract

Objective: To evaluate immediate and midterm results with percutaneous aortic valvoplasty. Material and Methods: We reviewed the records of 141 patients undergoing percutaneous aortic valvopasty over a period of 13 years. Results: The patients were aged from 2 months to 40 years, with a mean of 10.9 ± 9.9 years. Of the total, 90 (63%) were male. The initial systolic peak-to-peak gradient decreased from 163 ± 52 mmHg to 32 ± 18 mmHg (p > 0.01) after valvoplasty in all 141 patients, while the proportional reduction ranged from 0 to 100%, with a mean of 72 ± 27%. The index of the size of the balloon to the diameter of the valvar orifice was 0.88 ± 0.19 in 128 patients. The follow-up ranged from 6 to 168 months, with a mean 51 ± 48 months in 70 patients. A significant difference was found in those failing after dilation when the initial evaluation was compared to the final evaluation of patients with follow-up. In those failing, the number of patients rose from 12 (17%) to 21 (30%) (p > 0.01). In contrast, in those in whom we achieved success, there was not such a great difference between the initial and final evaluation: 58 (83%) versus 49 (70%) (p > 0.1). The actuarial freedom curve of patients not needing new percutaneous aortic valvoplasty or surgery, by 182 months, was at 87% and 82% respectively. Conclusion: We have reviewed the largest series of patients in Latin-America reported thus far after undergoing percutaneous aortic valvoplasty, concentrating on mid term follow-up and limitations. New prospective and multicentric studies are needed from our region.

Keywords

Arterial valveinterventional catheterisationballoon valvoplasty
Type
Original Articles
Information
Cardiology in the Young , Volume 12 , Issue 4 , July 2002 , pp. 328 - 332
Copyright
Copyright © Cambridge University Press 2002

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References

1.Lababidi, Z.Aortic balloon valvuloplasty. Am Heart J 1983; 106: 751–752.CrossRefGoogle ScholarPubMed
2.Rocchini, AP, Beekman, RH, Shachar, GB, Benson, L, Schwartz, D, Kan, JS.Balloon aortic valvuloplasty results and angioplasty of congenital anomalies registry. Am J Cardiol 1990; 65: 784–789.CrossRefGoogle ScholarPubMed
3.O'Connor, BK, Beekman, RH, Rocchini, AP, Rosenthal, A.Intermediate term effectiveness of balloon valvuloplasty for congenital aortic stenosis: prospective follow-up study. Circulation 1991; 84: 732–738.CrossRefGoogle ScholarPubMed
4.Shaddy, RE, Boucek, MM, Sturterant, JE, Ruttenberg, HD, Orsmand, GS.Gradient reduction, aortic valve regurgitation and prolapse after balloon aortic valvuloplasty in 32 consecutive patients with congenital aortic stenosis. J Am Coll Cardiol 1990; 16: 451–456.CrossRefGoogle ScholarPubMed
5.Vogel, M, Benson, LN, Burrows, P, Smallborn, J, Freedom, RM.Balloon dilatation of congenital aortic valve stenosis in infants and children: short term and intermediate results. Br Heart J 1989; 63:148–153.CrossRefGoogle Scholar
6.Moore, P, Egito, E, Mowrey, H, Perry, SB, Lock, JE, Keane, JF.Midterm results of balloon dilatation of congenital aortic stenosis: predictors of success. J Am Coll Cardiol 1996; 27: 1257–1268.CrossRefGoogle ScholarPubMed
7.Galal, O, Rao, PS, Fadel, Al-Fadley, Wilson, AD.Follow-up results balloon aortic valvuloplasty in children with special reference the causes of late aortic insufficiency. Am Heart J 1996; 133: 418–427.CrossRefGoogle Scholar
8.Egito, ES, Moore, P, O'Sullivan, J et al. , Transvalvular balloon dilation for neonatal critical aortic stenosis: early and midterm results. J Am Coll Cardiol 1997; 29: 442–447.CrossRefGoogle Scholar
9.Shim, D, Lloyd, TR, Beekman, RH III., Usefulness of repeat balloon aortic valvuloplasty in children. Am J Cardiol 1997; 79: 1141–1143.CrossRefGoogle ScholarPubMed
10.Brian, MW.Independent predictors of immediate results of percutaneous balloon aortic valvulotomy in childhood. Am J Cardiol 1996; 77: 286–293.Google Scholar
11.Robinson, BV, Brzezinska-Rajszys, G, Weber, HS et al. , Balloon aortic valvuloplasty through a carotid cutdown in infants with severe aortic stenosis: results of the multi-centric registry. Cardiol Young 2000; 10: 225–232.CrossRefGoogle Scholar
12.Dolan, MS, Catello, R, St Vrain, JA, Agirre, F, Labovitz, AJ.Quantization of aortic regurgitation by Doppler echocardiography: a practical approach. Am Heart J 1995; 129: 1014–1020.CrossRefGoogle Scholar
13.Wren, C, Sullivan, I, Bull, C, Deanfield, J.Percutaneous balloon dilation of aortic valve stenosis in neonates and infants. Br Heart J 1987; 58: 608–612.CrossRefGoogle ScholarPubMed
14.Rao, PS, Thapar, MK, Wilson, AD, Levy, JM, Chopra, PS.Intermediate term follow-up results of balloon aortic valvuloplasty in infants and children with special reference to causes of restenosis. Am J Cardiol 1989; 64: 1356–1360.CrossRefGoogle ScholarPubMed
15.McCrindle, BW, Brian, W.Independent predictors of immediate results of percutaneous balloon aortic valvulotomy in childhood. Am J Cardiol 1996; 77: 286–293.CrossRefGoogle Scholar
16.Justo, RN, McCrindle, B, Benson, LN, Williams, WG, Freedom, RM, Smallhorn, JF.Aortic valve regurgitation after surgical versus percutaneous balloon valvotomy for congenital aortic valve stenosis. Am J Cardiol 1996; 77: 1332–1338.CrossRefGoogle ScholarPubMed
17.Solymar, L, Sudow, G, Berggren, H, Eriksson, B.Balloon dilatation of stenotic aortic valve in children: an intra operative study. J Thorac Cardiovasc Surg 1992; 104: 1709–1713.CrossRefGoogle Scholar
18.Fischer, DR, Ettedegui, JA, Park, SC, Siewers, RD, del Nido, P.Carotid approach for balloon dilatation of aortic valve stenosis in the neonate: a preliminary report. Am J Cardiol 1990; 15: 1633–1636.CrossRefGoogle ScholarPubMed
19.O'Laughlin, MP, Slack, MC, Grifka, R, Mullins, CE.Prograde double balloon dilation of congenital aortic valve stenosis: a case report. Cathet Cardiovasc Diagn 1993; 28: 134–136.CrossRefGoogle ScholarPubMed
20.Hausdorf, G, Schneider, M, Schirmer, KR, Schulze-Neick, J, Lange, PE.Antegrade balloon valvuloplasty of aortic stenosis in children. Am J Cardiol 1993; 71: 460–462.CrossRefGoogle Scholar
21.Chartrand, CC, Saro-Serrando, E, Vobecky, JS.Long term results of surgical valvuloplasty for congenital valvar aortic stenosis in children. Ann Thorac Surg 1999; 68: 1356–1360.CrossRefGoogle ScholarPubMed
22.Lambert, V, Obreja, D, Losay, J et al. , Long-term results after valvulotomy for congenital aortic valvar stenosis in children. Cardiol Young 2000; 10: 590–596.CrossRefGoogle Scholar