IMMEDIATE AND MIDTERM RESULTS OF BALLOON AORTIC VALVULOPLASTY IN CHILDREN WITH AORTIC VALVE STENOSIS WITH SPECIAL REFERENCE TO DYSPLASTIC AORTIC VALVE

Haseen Dil Wazir, Ahmad Usaid Qureshi, Syed Najam Hyder, Masood Sadiq

Abstract


Background: This study was conducted to determine the immediate and midterm outcome of balloon aortic valvuloplasty in children from age 1 month to 16 years, with special reference to mean balloon to aortic valve ratio along with dooming versus dysplastic valve. Methods: This was a retrospective cohort study. Patients who underwent balloon aortic valvuloplasty in a single tertiary care hospital were reviewed regarding immediate outcome, morphology of aortic valve, mean balloon to aortic valve ratio and complications during procedure from January 2006 till December 2016. Results: Of 171 patients, 80.11% had fall to good results while 73.1% had adequate outcome. Mean gradient fall of more than 50% or Peak systolic gradient decreased significantly post ballooning, which indicates good results. The age ranges from 1–92 months, 89.4% patients from age group less than1 year had adequate outcome, (p=0.017). In terms of morphology, 55.6% cases had doming while 44.4% cases had dysplastic aortic valve. There was no significant difference between dysplastic and doming valves in terms of outcome (p=0.224). Only 6 patients (3.5%) developed significant aortic regurgitation. Regarding short-term and intermediate outcome 92% of the patient were free from a second intervention and there was no significant difference between complications regarding balloon to aortic valve ratio also. Conclusion: Our 10-year experience showed that balloon aortic valvuloplasty is a safe and effective therapy, irrespective of age groups. The complications rate is low and good outcome is achieved by keeping balloon to aortic valve ratio of ±0.9 irrespective of morphology of valve.

Keywords: Children; Congenital aortic valve stenosis; Balloon aortic valvuloplasty

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