Background:Balloon valvuloplasty was established as alternative to surgery for therapy of aortic valve stenosis in childhood. Acute complication after balloon dilatation leading to early death was described.Development of aortic insufficiency remains unwanted complication.
Aim of work:analyze early outcome and midterm results of balloon valvuloplasty of aortic valve in Children Hospital Mansoura University
Subjects and Methods: Between April 2005 - June 2008, all consecutive patients of age < 18 years treated for aortic valve stenosis with balloon valvuloplasty were analyzed retrospectively. patients were 21 , age 1mo to 10 years (mean age 5.6 years), 17 males, 4 females. Mean duration of follow up was 21 months. Two were neonates. All patients had isolated aortic valve stenosis except 3(14.3%) had associated aortic coarctation. Patients with gradient >50 mmHg were included; patients with aortic valve insufficiency >grade 1 were excluded. 6 (28.6%) had bicuspid aortic valve. All had normal myocardial function except one (4.8%)with LV FS of 15%
Results: Femoral artery was used in 20 patients(95.2%) and carotid artery in one neonate( 4.8%).Balloon/ annulus ratio was 0.83 +/- 0.04 .Significant relief of catheter gradient was acheived(mean 69 +/- 13mmHg to17 +/- 4 mmHg) (P<0.001) .2 patients (9.5%) were followed by grade II incompetence, 9(42.8%)by grade I aortic incompetence. 2 early deaths(9.5%); one died because of severe aortic insufficiency,a neonate died because of severely compromised LV; one patient (8.3%)had impalpable femoral pulsation necessitating anticoagulation. Patients remained free from Reintervention.
Conclusion: Balloon valvuloplasty of aortic valve stenosis significantly reduces gradient with low morbidity and mortality.