title: Gradient reduction, aortic valve regurgitation and prolapse after balloon aortic valvuloplasty in 32 consecutive patients with congenital aortic stenosis.
abstract: From 1986 to 1988, balloon aortic valvuloplasty was performed in 32 patients with congenital valvular aortic stenosis. The patients ranged in age from 2 days to 28 years (mean +/- SD 8.3 +/- 5.9). One balloon was used in 17 patients and two balloons were used in 15 patients. Immediately after valvuloplasty, peak systolic pressure gradient across the aortic valve decreased significantly from 77 +/- 27 to 23 +/- 16 mm Hg (p less than 0.01), a 70% reduction in gradient. At early follow-up study (4.1 +/- 3.3 months after valvuloplasty), there was a 48 +/- 20.5% reduction in gradient compared with that before valvuloplasty, and at late follow-up evaluation (19.2 +/- 5.6 months), a reduction in gradient of 40 +/- 29% persisted. Echocardiography showed evidence of significantly increased aortic regurgitation in 10 patients (31%) and aortic valve prolapse in 7 patients (22%). There was no correlation between the balloon/anulus ratio and the subsequent development of aortic regurgitation or prolapse. In fact, no patient who showed a significant increase in aortic regurgitation had had a balloon/anulus ratio greater than 100%. It is concluded that balloon aortic valvuloplasty effectively reduces peak systolic pressure gradient across the aortic valve in patients with congenital aortic stenosis. However, subsequent aortic regurgitation and prolapse occur in a significant number of patients, even if appropriate technique and a balloon size no greater than that of the aortic anulus are used.
authors.affiliation: Department of Pediatrics, University of Utah, Salt Lake City.
authors.forename: R E
authors.initials: RE
authors.lastname: Shaddy
authors.forename: M M
authors.initials: MM
authors.lastname: Boucek
authors.forename: J E
authors.initials: JE
authors.lastname: Sturtevant
authors.forename: H D
authors.initials: HD
authors.lastname: Ruttenberg
authors.forename: G S
authors.initials: GS
authors.lastname: Orsmond
mesh_terms: D000293:Adolescent; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology*; D001023:Aortic Valve Prolapse / Q000453:epidemiology*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000151:congenital* / Q000503:physiopathology / Q000628:therapy; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D011312:Pressure