Premium
Repeat balloon dilation of congenital valvar aortic stenosis: Immediate results and midterm outcome
Author(s) -
Satou Gary M.,
Perry Stanton B.,
Lock James E.,
Piercey Gary E.,
Keane John F.
Publication year - 1999
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(199905)47:1<47::aid-ccd10>3.0.co;2-o
Subject(s) - medicine , stenosis , cardiology , balloon dilation , asymptomatic , aortic valve stenosis , balloon , regurgitation (circulation) , balloon dilatation , surgery
While balloon dilation (BD) has become the initial treatment for congenital valvar aortic stenosis (CVAS) at many institutions, repeat BD for recurrent obstruction has been reported only in a few. Between January 1985 and December 1996, 298 patients (70 neonates) underwent BD, 34 of whom underwent a repeat BD without mortality. A greater proportion of neonates had a repeat BD (26% vs. 8%, P < 0.001). At repeat BD (1 day–7.5 years post initial BD), the mean peak‐to‐peak gradient was reduced from 67 ± 24 to 36 ± 16 mm Hg ( P < 0.0001). Aortic regurgitation (AR) increased immediately in 26%, being moderate or more in 24%. During a mean follow‐up of 5.2 years, there was one surgically related death. Of the 33 survivors, 6 had surgery for residual stenosis and/or AR. Among the remaining 27 patients, 96% were asymptomatic, the peak instantaneous aortic valve Doppler gradient was 50 ± 15 mm Hg with AR absent in 8%, mild in 62%, and moderate or more in 31%. In conclusion, repeat BD is effective and without mortality. AR was at least moderate in 24% of patients immediately after a second BD. Repeat BD was more common in patients who underwent the initial BD as neonates. Cathet. Cardiovasc. Intervent. 47:47–51, 1999. © 1999 Wiley‐Liss, Inc.