title: Long term results of percutaneous balloon valvoplasty of congenital aortic stenosis: independent predictors of outcome.
abstract: OBJECTIVE
  To evaluate long term results and independent predictors of outcome of aortic valvoplasty.
  
  
  METHODS
  Retrospective follow up study. Independent predictors of outcome identified by multiple logistic regression.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  269 consecutive patients treated at the median age of 8 months (0-23 years): 80 (30%) under 4 weeks, 59 (22%) between 4 weeks and 1 year, and 130 (48%) over 1 year. The follow up period was up to 14.8 years (median 5.3, in survivors 6.4 years).
  
  
  METHODS
  Percutaneous balloon valvoplasty with mean (SD) balloon to annulus ratio 0.97 (0.08).
  
  
  METHODS
  Restenosis > or = 70 mm Hg, grade 3 aortic insufficiency, cusps disruption, surgery, death, and valvoplasty failure (significant restenosis or insufficiency or surgery or death).
  
  
  RESULTS
  The mortality rate was 10.4% (n = 28), the restenosis rate was 16.7% (n = 45), significant insufficiency developed in 22.3% (n = 60), surgery was needed in 20.1% (n = 54), and "valvoplasty failure" occurred in 41.6% (n = 112) patients. Mean (SEM) survival probability 14.4 years after the procedure was 0.89 (0.02) and mean (SEM) probability of surgery-free survival was 0.50 (0.08). The independent predictors were as follows. For restenosis: small aortic annulus; for cusp disruption: large aortic annulus; for insufficiency: bicuspid aortic valve; for need for surgery: bicuspid aortic valve; for death: small aortic annulus, low left ventricular shortening fraction, and low sequential number of the valvoplasty; and for valvoplasty failure: small aortic annulus, bicuspid aortic valve, and high grade of mitral insufficiency.
  
  
  CONCLUSIONS
  Independent predictors of unfavourable outcome are small aortic annulus, bicuspid aortic valve, poor function of left ventricle or mitral valve, and limited operator experience.
authors.affiliation: Kardiocentrum, University Hospital Motol, Prague, Czech Republic. oleg.reich@lfmotol.cuni.cz
authors.forename: O
authors.initials: O
authors.lastname: Reich
authors.forename: P
authors.initials: P
authors.lastname: Tax
authors.forename: J
authors.initials: J
authors.lastname: Marek
authors.forename: V
authors.initials: V
authors.lastname: Rázek
authors.forename: J
authors.initials: J
authors.lastname: Gilík
authors.forename: V
authors.initials: V
authors.lastname: Tomek
authors.forename: V
authors.initials: V
authors.lastname: Chaloupecký
authors.forename: H
authors.initials: H
authors.lastname: Bartáková
authors.forename: J
authors.initials: J
authors.lastname: Skovránek
mesh_terms: D000293:Adolescent; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000628:therapy; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000628:therapy*; D002404:Catheterization / Q000379:methods* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome