title: [Our medium-term results with aortic balloon valvuloplasty and factors affecting development of aortic regurgitation].
abstract: OBJECTIVE
  The objective of this study was to assess medium-term results of aortic balloon valvuloplasty (ABV) in congenital aortic stenosis and to determine factors affecting development of aortic regurgitation (AR).
  
  
  METHODS
  Between September 2003 and January 2010, 114 ABV procedures performed on 97 patients analyzed retrospectively. Patients were evaluated in terms of transvalvular gradients before and after procedure, development of new aortic insufficiency or increase in the current insufficiency and factors affecting the procedural success and development of aortic insufficiency. In addition, follow up results were also evaluated in terms of restenosis and increase or decrease of aortic regurgitation. Student's t-test, ANOVA for repeated measurements, linear discriminant and Kaplan-Meier survival analyses were used for statistical analysis.
  
  
  RESULTS
  The mean age was 6.63±6.33 year (2 days-21 years). Mean follow-up was 32.6±25.1 months (1 to 75 months). Thirty-seven patients were infant (<1 year) and 18 of them were newborn. The peak systolic pressure gradient decreased from 77.2±24.9 mmHg to 28.5±12.9 mmHg (p=0.0001). Eighty-two procedures were optimal, 29 suboptimal and 3 were unsuccessful. AR developed in totally 53 patients, 16 of them were significant degree. Balloon /annulus ratio and the percentage of reduction in gradient was meaningfully higher in patients with significant aortic regurgitation (p=0.02 and p=0.03, respectively). Infants show more significant AR (9/37, 24%) in comparison with bigger patients (7/77, 9%) (p=0.02). Four patients died after procedure at intensive care unit, three of them were newborn.
  
  
  CONCLUSIONS
  ABV is safe and effective palliative method for the treatment of congenital aortic stenosis. AR, which was the most common complication, incidence was increased in infancy and was related with high balloon/annulus ratio and high reduction in gradient.
authors.affiliation: Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Pediyatrik Kardiyoloji Kliniği, İstanbul, Türkiye.
authors.forename: Celal
authors.initials: C
authors.lastname: Akdeniz
authors.forename: Abdullah
authors.initials: A
authors.lastname: Erdem
authors.forename: Fadli
authors.initials: F
authors.lastname: Demir
authors.forename: Türkay
authors.initials: T
authors.lastname: Sarıtaş
authors.forename: Cenap
authors.initials: C
authors.lastname: Zeybek
authors.forename: Halil
authors.initials: H
authors.lastname: Demir
authors.forename: Yalım
authors.initials: Y
authors.lastname: Yalçın
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celebi
mesh_terms: D000293:Adolescent; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000401:mortality / Q000628:therapy*; D002404:Catheterization / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult