title: [Balloon valvuloplasty for congenital aortic valve stenosis in children].
abstract: OBJECTIVE
  To evaluate the efficacy and safety of percutaneous balloon aortic valvuloplasty (PBAV) for congenital aortic valve stenosis in children.
  
  
  METHODS
  This is a retrospective clinical study including 14 children treated with PBAV for congenital aortic valve stenosis from October 2006 to December 2012 in our institute. During clinical follow-up, aortic residual stenosis and restenosis, left ventricular function and the procedure-related complications, including the approach artery injury, and aortic regurgitation were particularly assessed.
  
  
  RESULTS
  A total of 14 patients consisting of 12 boys and 2 girls underwent the procedure, with mean age (17.1 ± 10.5) months (range from 8 days to 6 years) and the mean body weight (8.9 ± 5.5) kg (range from 1.9 kg to 23.0 kg). The indication for PBAV was a Doppler-derived peak instaneous gradient of ≥ 75 mmHg(1 mmHg = 0.133 kPa) or a smaller gradient with signs of severe left ventricular dysfunction or left ventricular strain on the ECG. The mean ratio of balloon-annulus was 0.92 ± 0.09 (range from 0.75 to 1.09). The catheter-measured peak systolic valve gradient was successfully relieved in all the patients, decreasing from (69 ± 26) mmHg to (29 ± 13) mmHg immediately after balloon valvuloplasty (t = 7.628, P = 0.000). The Doppler-derived peak and mean gradient decreased from (95 ± 21) mmHg and (50 ± 7) mmHg to (49 ± 16) mmHg and (24 ± 11) mmHg, respectively (t = 7.630, 10.401; P = 0.000, 0.000) . The mean follow-up period was 1 day to 61 months. At follow-up, 2 patients (2/14, 14%) underwent the second balloon valvuloplasty for the significant restenosis, and both showed successful relief of restenosis, however 1 patient required surgical Ross procedure due to significant recurrent systolic pressure gradient and moderate aortic regurgitation 4 years after the second balloon valvuloplasty. Among the 3 young infants who presented with congestive heart failure before intervention, 1 died 1 day after the procedure, the other 2 patients had improved left ventricular systolic function significantly during post-procedural follow-up. Only 1 patient (1/14, 7%) developed moderate aortic regurgitation. There was no other procedure-related complication.
  
  
  CONCLUSIONS
  PBAV for congenital aortic valve stenosis is effective and safe in children. It is a very feasible palliative intervention for children with severe aortic valve stenosis to postpone the aortic valve surgery.
authors.affiliation: Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wu
authors.affiliation: Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
authors.forename: Chunhua
authors.initials: C
authors.lastname: Qi
authors.affiliation: Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
authors.forename: Lan
authors.initials: L
authors.lastname: He
authors.affiliation: Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China.
authors.forename: Guoying
authors.initials: G
authors.lastname: Huang
mesh_terms: D001011:Aorta; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency; D001024:Aortic Valve Stenosis / Q000151:congenital* / Q000628:therapy*; D063126:Balloon Valvuloplasty; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013599:Systole; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left; D016277:Ventricular Function, Left