Percutaneous aortic valvoplasty in congenital aortic valvar stenosis.
OBJECTIVE
To evaluate immediate and midterm results with percutaneous aortic valvoplasty.


METHODS
We reviewed the records of 141 patients undergoing percutaneous aortic valvopasty over a period of 13 years.


RESULTS
The patients were aged from 2 months to 40 years, with a mean of 10.9 +/- 9.9 years. Of the total, 90 (63+/%) were male. The initial systolic peak-to-peak gradient decreased from 163 +/- 52 mmHg to 32 +/- 18 mmHg (p < 0.01) after valvoplasty in all 141 patients, while the proportional reduction ranged from 0 to 100%, with a mean of 72 +/- 27%. The index of the size of the balloon to the diameter of the valvar orifice was 0.88 +/- 0.19 in 128 patients. The follow-up ranged from 6 to 168 months, with a mean 51 +/- 48 months in 70 patients. A significant difference was found in those failing after dilation when the initial evaluation was compared to the final evaluation of patients with follow-up. In those failing, the number of patients rose from 12 (17%) to 21 (30%) (p < 0.01). In contrast, in those in whom we achieved success, there was not such a great difference between the initial and final evaluation: 58 (83%) versus 49 (70%) (p < 0.1). The actuarial freedom curve of patients not needing new percutaneous aortic valvoplasty or surgery, by 182 months, was at 87% and 82% respectively.


CONCLUSIONS
We have reviewed the largest series of patients in Latin-America reported thus far after undergoing percutaneous aortic valvoplasty, concentrating on mid term follow-up and limitations. New prospective and multicentric studies are needed from our region.
Congenital Heart Disease Department, Hospital de Cardiología, National Medical Centre Siglo XXI, Mexico City, Mexico. alva1@prodigy.net.mx
Carlos
C
Alva
Agustín
A
Sánchez
Felipe
F
David
Santiago
S
Jiménez
David
D
Jiménez
José
J
Ortegén
Martha
M
Hernández
José Antonio
JA
Magaña
Rubén
R
Argüero
Mariano
M
Ledesma
D000293:Adolescent; D000328:Adult; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000601:surgery*; D002404:Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008800:Mexico; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome