title: The Impact of Rapid Left Ventricular Pacing during Pediatric Aortic Valvuloplasty on Postprocedural Aortic Insufficiency.
abstract: OBJECTIVE
  This study aims to determine efficacy and safety of rapid left ventricular pacing (RLVP) during balloon aortic valvuloplasty and effect on development of postprocedural aortic insufficiency (AI) in children.
  
  
  METHODS
  This is a retrospective comparison of 56 children (mean age 18.3 month; 1 day-15 years of age) who underwent valvuloplasty by using RLVP with standard method (without pacing) during same time period (74 children; mean age 12.6 month; 1 day-18 years of age).
  
  
  RESULTS
  The systolic valvular gradient decreased from a mean 67 ± 20.4 mm Hg (26-120 mm Hg) before the procedure to a mean 27.6 ± 17.8 mm Hg (0-120 mm Hg) after the procedure. Procedure failed in two of the patients (3.6%) who received the RLVP; only two patients developed severe AI. Among those patients who underwent the standard method procedure failed in 6 patients (8.3%), whereas severe AI was seen in 15 (20.2%). RLVP decreased the incidence of postprocedure severe AI significantly (P < .01) but it had no effect on the gradient reduction of the procedure (P > .05). RLVP did not change the procedure duration, but decreased the duration of fluoroscopy significantly (P < .01).
  
  
  CONCLUSIONS
  RLVP can be used effectively and safely for pacing during balloon aortic valvuloplasty procedures in all age groups; it decreases procedural failure rate, eases the procedure and prevents the development of AI through the stabilization of the balloon.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Ertugrul
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Karagoz
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Koc University, Ankara, Turkey.
authors.forename: Alpay
authors.initials: A
authors.lastname: Celiker
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Dursun
authors.initials: D
authors.lastname: Alehan
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Ozer
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Suheyla
authors.initials: S
authors.lastname: Ozkutlu
mesh_terms: D000293:Adolescent; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D063126:Balloon Valvuloplasty / Q000009:adverse effects*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Balloon Valvuloplasty; Congenital Aortic Stenosis; Rapid Left Ventricular Pacing