Aortic balloon dilatation for congenital aortic stenosis: report of 90 cases (1986-98).
نویسندگان
چکیده
OBJECTIVE To review 12 years of experience of balloon aortic valvoplasty in childhood. DESIGN Early and mid-term clinical and instrumental evaluation of 104 consecutive balloon aortic valvoplasties performed from 1986 to 1998. SETTING A tertiary referral centre for congenital heart disease. PATIENTS 90 patients with congenital aortic stenosis: 20 neonates (group 1), 16 infants (group 2), and 54 children (group 3). INTERVENTIONS Balloon aortic valvotomy. MAIN OUTCOME MEASURES Doppler and peak to peak aortic gradient before and after valvoplasty, degree of aortic regurgitation before and after valvoplasty, early and late mortality, need for repeat intervention or surgery. RESULTS Balloon aortic valvoplasty produced a gradient reduction of > 50% in 59 patients, 12 having a residual peak to peak gradient of > 50 mm Hg. Early mortality included three procedure related and six procedure unrelated deaths. There were no intraprocedural deaths. Grade III aortic regurgitation occurred in 20 patients. Five non-lethal complications occurred. At a mean follow up of 5.1 (group 1), 5.7 (group 2), and 7.6 years (group 3), survival was 75%, 88%, and 96%, respectively. Redilatation was performed in three patients in group 1, one in group 2, and 10 in group 3. Surgery was necessary for six in group 1, one in group 2, and eight in group 3. Freedom from events at last follow up was 50%, 75%, and 64%, respectively. There was a residual maximum Doppler gradient of < 30 mm Hg in 22 patients and > 60 mm Hg in 23; 50 patients have mild to moderate aortic regurgitation. CONCLUSIONS Balloon aortic valvoplasty is effective and repeatable and offers good palliation for congenital aortic stenosis in childhood.
منابع مشابه
مقایسه نتایج درمانی بالون والوپلاستی و والوتومی جراحی در بیماران مبتلا به تنگی مادرزادی دریچه آئورت در پیگیری 6 ساله در بخش کودکان بیمارستان قلب شهید رجایی تهران
Background: Balloon valvuloplasty is a relatively new technique for relief of obstruction of aortic valve. The primary results of this procedure are similar to surgical valvotomy with fewer complications and mortality. Materials and methods: One hundred fifty-five patients with congenital aortic stenosis were enrolled in this study over a period of 6 years (1991-1997). Participants were all un...
متن کاملTranscatheter treatment of pulmonary stenosis and coarctation of the aorta: experience with percutaneous balloon dilatation.
Twenty two children (age range 4 months-20 years) with pulmonary valve stenosis and ten children (age range 1 month-11 years) with coarctation of the aorta underwent balloon dilatation in the 29 month period between October 1983 and February 1986. Number 5-9 French catheters with 5-20 mm balloons were used according to the size of the angiographically measured pulmonary valve annulus or coarcte...
متن کاملSUPRAVALVAR AORTIC STENOSIS IN CHILDREN REPORT OF THIRTEEN CASES
During 15 years from 1975 to 1990, thirteen cases of supravalvar aortic stenosis were admitted at the pediatrics department of Shahid Rajai Heart Hospital, Tehran. All patients were subjected to cardiac catheterization and a angiocardiography. Patients ranged in age from 3.5 years to 14 years with a mean of 8.7 years. Seventy seven percent of childen were male. Eight cases (61.5%) had Wil...
متن کاملبررسی نتایج پیگیری یک ساله بالون والولوپلاستی تنگی مادرزادی دریچه آئورت در کودکان به مدت 10 سال در بیمارستان قلب شهید رجایی
Abstract Background: Balloon valvuloplasty uses for treatment of aortic stenosis from 20 years ago. Regarding loss of information about results of balloon valvuloplasty of hereditary aortic stenosis, this study was done to determine prognosis and complication of balloon valvuloplasty during last 10 years. Methods: This study was done on existing data of all children with hereditary aortic...
متن کاملBalloon dilatation of congenital aortic valve stenosis in infants and children: short term and intermediate results.
Percutaneous balloon dilatation of the aortic valve was attempted in 25 consecutive patients with stenosis. The aortic valve diameters were normal for age. The balloon catheters were placed retrogradely, and their diameters were within 1-2 mm of the valve diameter and 3 (13 patients) or 6 cm (recent 12 patients) long. After dilatation the pressure gradients across the aortic valve were reduced ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Heart
دوره 82 6 شماره
صفحات -
تاریخ انتشار 1999