title: Balloon Valvuloplasty of Aortic Valve Stenosis in Childhood: Midterm Results in a Children's Hospital, Mansoura University, Egypt.
abstract: BACKGROUND
  Balloon valvuloplasty was established as an alternative to surgery for treatment of aortic valve stenosis in childhood. Acute complications after balloon dilatation including aortic insufficiency or early death were described.
  
  
  OBJECTIVE
  To analyze early outcome and midterm results of balloon aortic valvuloplasty (BAV) in Children's Hospital, Mansoura University, Egypt.
  
  
  METHODS
  Between April 2005-June 2008, all consecutive patients of age <18 years treated for aortic valve stenosis (AVS) with BAV were analyzed retrospectively. The study included 21 patients; 17 males, and 4 females. Their age ranged from the neonatal period to 10 years (mean age 5.6 ± 3.7 years). Patients with gradient ≥50 mmHg and aortic valve insufficiency (AI) up to grade I were included. All patients had isolated aortic valve stenosis except 3 patients (14.3%) had associated aortic coarctation. Six patients (28.6%) had bicuspid aortic valve. All patients had normal myocardial function except one (4.8%) had FS 15%. The duration of follow up was (mean ± SD: 18.5 ± 11.7 months).
  
  
  RESULTS
  Femoral artery approach was used in 20 patients (95.2%) and carotid artery in one neonate (4.8%). Balloon/annulus ratio was 0.83 ± 0.04. Significant reduction in pressure gradient was achieved (mean 66.7 ± 9.8 mmHg to 20.65 ± 2.99 mmHg) (P < 0.001). Nine patients (42.8%) developed grade I AI, 2 patients (9.5%) developed grade II AI and 1 patient (4.8%) developed grade III AI. Two early deaths (9.5%); one died due to heart failure caused by grade IV AI and a neonate died because of severely compromised LV function. One patient (4.8%) had femoral artery occlusion necessitating anticoagulation. Patients remained free from re-intervention during follow up.
  
  
  CONCLUSIONS
  Balloon valvuloplasty of aortic valve stenosis significantly reduces gradient with low morbidity and mortality in children.
authors.affiliation: Pediatric Cardiology Unit.
authors.forename: Hala
authors.initials: H
authors.lastname: Al Marshafawy
authors.forename: Gehan Attia
authors.initials: GA
authors.lastname: Al Sawah
authors.forename: Mona
authors.initials: M
authors.lastname: Hafez
authors.forename: Mohammed
authors.initials: M
authors.lastname: Matter
authors.forename: Adel
authors.initials: A
authors.lastname: El Gamal
authors.forename: Abdel Gawad
authors.initials: AG
authors.lastname: Sheishaa
authors.forename: Magdy Abu
authors.initials: MA
authors.lastname: El Kair