title: Balloon aortic valvuloplasty for congenital aortic stenosis using the femoral and the carotid artery approach: a 16-year experience from a single center.
abstract: OBJECTIVE
  The aim of this article is to report a 16-year experience with percutaneous balloon aortic valvuloplasty (BAVP) in newborns and young infants up to 3 months of age in a tertiary care cardiac reference center in a developing country and to determine its value in postponing open heart surgery.
  
  
  BACKGROUND
  Congenital aortic stenosis (AS) is a potentially life threatening disorder. BAVP and surgical procedures have similar short and medium-term efficacy.
  
  
  METHODS
  Thirty-one consecutive newborns and young infants with critical AS underwent BAVP in our department from 1991 to 2007. Mean patient age at time of the procedure was 22 days (range 2-92 days) and mean weight was 3,310 g (1,840-4,400 g).
  
  
  RESULTS
  There was a significant reduction in mean Doppler-derived peak gradient across the aortic valve immediately after the procedure (75.1 ± 22 versus 32.2 ± 13.02, P < 0.001), and this finding was maintained throughout follow-up. Since 2003, when the carotid approach became routine practice, no major vascular complications were observed. Mean time of follow-up was 81 months (5 days-196 months) with only two deaths (7.4%). Only 24% patients required surgical reintervention on the aortic valve during follow-up. Survival free from aortic valve surgery was 80% at 24 months, 66% at 63 months, and 50% at 80 months.
  
  
  CONCLUSIONS
  Percutaneous intervention for relief of critical aortic stenosis in newborns in a tertiary center of a developing country is safe and has excellent short and long-term results comparable to other centers throughout the world.
authors.affiliation: Hemodynamic Service, Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Brasil. editoracao-pc@cardiologia.org.br
authors.forename: Raul I
authors.initials: RI
authors.lastname: Rossi
authors.forename: João L L
authors.initials: JL
authors.lastname: Manica
authors.forename: Ricardo
authors.initials: R
authors.lastname: Petraco
authors.forename: Mônica
authors.initials: M
authors.lastname: Scott
authors.forename: Luciane
authors.initials: L
authors.lastname: Piazza
authors.forename: Paulo M
authors.initials: PM
authors.lastname: Machado
mesh_terms: D001024:Aortic Valve Stenosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001938:Brazil; D006348:Cardiac Surgical Procedures; D002339:Carotid Arteries; D002404:Catheterization / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003906:Developing Countries; D018572:Disease-Free Survival; D015150:Echocardiography, Doppler; D005260:Female; D005263:Femoral Artery; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome