[Balloon dilatation of congenital aortic stenoses].
Percutaneous balloon valvuloplasty was performed between 1984 and 1987 on 27 occasions in 25 patients with congenital aortic valve stenosis. Eight infants underwent ten dilatation procedures (two redilatations included); seven of these eight infants had critical aortic valve stenosis and one infant asymptomatic severe valve stenosis. One additional 5-day-old newborn died after left ventricular perforation, probably caused by the exchange wire during cardiac catherization immediately before valvuloplasty, despite emergency operation. The transvalvular pressure gradient was reduced in these eight infants from 73 +/- 5 to 36 +/- mmHg (p less than 0.01). Five infants were restudied after an interval of 3-6 months and redilatation performed in two patients with residual stenosis. One infant developed mild aortic incompetence and in one infant, mild aortic regurgitation following commissurotomy did not increase after two dilatation procedures at the age of 2 and 7 months. No aortic regurgitation was noted in the remaining 6 infants after dilatation. Valvuloplasty was also performed in 16 children and adolescents (4-25 years old, mean age 13 +/- 6 years) using balloons with inflated diameters 1 to 3 mm smaller than the aortic valve ring (15 single balloons, 1 trefoil balloon). Peak systolic pressure gradient decreased from 93 +/- 25 to 49 +/- mmHg (p less than 0.01). Mild aortic regurgitation was present in six patients (three following surgery) before dilatation and remained unchanged in five patients. In one patient, aortic incompetence increased slightly after valvuloplasty. Ten patients showed no evidence of aortic regurgitation after dilatation. Embolectomy of the femoral artery was performed in two patients 1-3 days after valvuloplasty. No further complications occurred.(ABSTRACT TRUNCATED AT 250 WORDS)
Medizinische Klinik II, Städtische Kliniken Kassel, West Germany.
K L
KL
Neuhaus
G
G
Rupprath
D000293:Adolescent; D000328:Adult; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn
Ballondilatation kongenitaler Aortenstenosen.