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. 2022 Jun;18(2):154-161.
doi: 10.5114/aic.2022.118532. Epub 2022 Aug 19.

Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome

Filip Tyc  1 , Michal Galeczka  1 , Jacek Białkowski  1 , Katarzyna Kulig  1 , Roland Fiszer  1
Affiliations

Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome

Filip Tyc et al. Postepy Kardiol Interwencyjnej. 2022 Jun.

Abstract

Introduction: Balloon aortic valvuloplasty (BAV) is a common treatment method of aortic valve (AV) stenosis in neonates. Long-term BAV effects are suboptimal, and their predictors are not well acknowledged.

Aim: To identify predictors of suboptimal short- and long-term BAV results.

Material and methods: The study group comprised forty-three neonates (8 females; weight 3.34 ±0.56 kg) who underwent BAV between 1998 and 2021. Seventeen patients (39.53%) had critical AV stenosis. AV was bicuspid in 22 patients, tricuspid in 12, unicuspid in 2, and undefined in 7 patients. The mean balloon/annulus ratio was 0.9 ±0.07. Catheterization, clinical, and follow-up data were analysed.

Results: The peak-to-peak gradient decreased from 67.5 ±26.3 to 21.3 ±12.6 mm Hg. Twenty-eight patients (65.1%) had adequate early outcome. Aortic regurgitation (AR) occurred in 13 (30.2%) patients. No predictors of inadequate early outcome were found. Twenty-year survival was 90.7%. Eleven (35.5%) patients underwent reintervention at a median of 12 (1-215) months; BAV in 5 patients, surgical valvuloplasty in 2, Ross operation in 2, AV replacement in 1, and Norwood operation in 1 patient. Fifteen-year freedom from reintervention (FFR) was 48%. Adequate early outcome resulted in higher FFR (71% vs. 22%), and so did no significant AR (60% vs. 30%).

Conclusions: BAV provides satisfying early results. AR remains a significant aftermath of BAV. Risk factors and procedural techniques improving the outcome of BAV are unclear. Further research is needed to improve FFR.

Keywords: balloon valvuloplasty; clinical outcome; congenital aortic stenosis; neonates; transcatheter treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Freedom from reintervention
Figure 2
Figure 2
Comparison of freedom from reintervention in patients with adequate vs. inadequate early outcome
Figure 3
Figure 3
Comparison of freedom from reintervention in patients with and without significant aortic regurgitation
Figure 4
Figure 4
Comparison of freedom from reintervention in patients with tricuspid and bicuspid AV
Figure 5
Figure 5
Comparison of freedom from reintervention in patients with critical and non-critical aortic stenosis
See this image and copyright information in PMC

References

    1. Auld B, Carrigan L, Ward C, et al. . Balloon aortic valvuloplasty for congenital aortic stenosis: a 14-year single centre review. Heart Lung Circ 2019; 28: 632-6. - PubMed
    1. Boe BA, Zampi JD, Kennedy KF, et al. . Acute success of balloon aortic valvuloplasty in the current era. JACC Cardiovasc Interv 2017; 10: 1717-26. - PubMed
    1. Vergnat M, Asfour B, Arenz C, et al. . Aortic stenosis of the neonate: a single-center experience. J Thorac Cardiovasc Surg 2019; 157: 318-26.e1. - PubMed
    1. Hill GD, Ginde S, Rios R, et al. . Surgical valvotomy versus balloon valvuloplasty for congenital aortic valve stenosis: a systematic review and meta-analysis. J Am Heart Assoc 2016; 5: e003931. - PMC - PubMed
    1. Hochstrasser L, Ruchat P, Sekarski N, et al. . Long-term outcome of congenital aortic valve stenosis: predictors of reintervention. Cardiol Young 2015; 25: 893-902. - PubMed