Skip to main content

Advertisement

SpringerLink
Log in

Balloon Dilation and Surgical Valvotomy Comparison in Non-critical Congenital Aortic Valve Stenosis

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Percutaneous balloon aortic valvoplasty (BAV) and surgical aortic valvotomy (SAV) are palliative procedures in patients with non-critical congenital valve stenosis. The aim of the study was to evaluate long-term BAV and SAV results after up to 24 years of follow-up. From 1987 to 2013, 74 consecutive interventions were performed in patients with aortic stenosis, and 62 were included in the study (39 BAVs and 23 SAVs). Age of BAV patients was 1.3 months to 17 years, and of SAV patients 1.2 months to 15 years. Although BAV patients were older, there was no difference between groups according to sex, valve function/morphology, and early/late follow-up results, with exception to hospitalization period. Significant pressure gradient reduction and aortic regurgitation increment were registered after procedures. Three patients did not survive early period after surgery. Follow-up period was 7.0 ± 5.4 and 9.0 ± 8.0 years after BAV and SAV, respectively (p = 0.242). Follow-up pressure gradient rose only in the BAV group, and was emphasized after 10-year-follow-up (p = 0.020). Significant aortic insufficiency progression was registered after 15 years of follow-up in both groups (p = 0.007 and p = 0.009, respectively). Mean reintervention-free survival was 12.0 years in the BAV and 14.5 years in the SAV group (p = 0.733), and mean survival without aortic valve replacement was 15.2 and 17.4 years, respectively (p = 0.877). BAV and SAV in patients with congenital aortic stenosis are very comparable in both early and late follow-up results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Alexiou C, Chen Q, Langley SM, Salmon AP, Keeton BR, Haw MP, Monro JL (2001) Is there still a place for open surgical valvotomy in the management of aortic stenosis in children? The view from Southampton. Eur J Cardiothorac Surg 20:239–246

    Article  CAS  PubMed  Google Scholar 

  2. Balmer C, Beghetti M, Fasnacht M, Friedli B, Arbenz U (2004) Balloon aortic valvoplasty in paediatric patients: progressive aortic regurgitation is common. Heart 90:77–81

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Bauer EP, Schmidli J, Vogt PR, Von Segesser LK, Turina MI (1992) Valvotomy for isolated congenital aortic stenosis in children: prognostic factors for outcome. Thorac Cardiovasc Surg 40:334–339

    Article  CAS  PubMed  Google Scholar 

  4. Bernstein D (2007) Aortic stenosis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF (eds) Nelson Textbook of Pediatrics -, 18th edn. Saunders Company, Philadelphia, pp 1898–1900

    Google Scholar 

  5. Borghi A, Agnoletti G, Valsecchi O, Carminati M (1999) Aortic balloon dilatation for congenital aortic stenosis: report of 90 cases (1986-98). Heart 82(6):e10

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Brown JW, Ruzmetov M, Vijay P, Rodefeld MD, Turrentine MW (2003) Surgery for aortic stenosis in children: a 40-year experience. Ann Thorac Surg 76:1398–1411

    Article  PubMed  Google Scholar 

  7. Brown DW, Dipilato AE, Chong EC, Lock JE, McElhinney DB (2010) Aortic valve reinterventions after balloon aortic valvuloplasty for congenital aortic stenosis. J Am Coll Cardiol 56:1740–1749

    Article  PubMed  Google Scholar 

  8. Brown JW, Rodefeld MD, Ruzmetov M, Eltayeb O, Yurdakok O, Turrentine MW (2012) Surgical valvuloplasty versus balloon aortic dilation for congenital aortic stenosis: are evidence-based outcomes relevant? Ann Thorac Surg 94:146–155

    Article  PubMed  Google Scholar 

  9. Chessa M, Carrozza M, Butera G, Negura D, Piazza L, Giamberti A, Feslova V, Bossone E, Vigna C, Carminati M (2006) The impact of interventional cardiology for the management of adults with congenital heart defects. Catheter Cardiovasc Interv 67:258–264

    Article  PubMed  Google Scholar 

  10. Ewert P, Bertram H, Breuer J, Dahnert I, Dittrich S, Eicken A et al (2011) Balloon valvuloplasty in the treatment of congenital aortic valve stenosis - A retrospective multicenter survey of more than 1000 patients. Int J Cardiol 149:182–185

    Article  CAS  PubMed  Google Scholar 

  11. Fratz S, Gildein HP, Balling G, Sebening W, Genz T, Eicken A, Hess J (2008) Aortic valvuloplasty in pediatric patients substantially postpones the need for aortic valve surgery: a single-center experience of 188 patients after up to 17.5 years of follow-up. Circulation 117:1201–1206

    Article  PubMed  Google Scholar 

  12. Gatzoulis MA, Rigby ML, Shinebourne EA, Redington AN (1995) Contemporary results of balloon valvuloplasty and surgical valvotomy for congenital aortic stenosis. Arch Dis Child 73:66–69

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Holzer RJ, Cheatham JP (2010) Shifting the balance between aortic insufficiency and residual gradients after balloon aortic valvuloplasty. J Am Coll Cardiol 56:1750–1751

    Article  PubMed  Google Scholar 

  14. Justo RN, McCrindle BW, Benson LN, Williams WG, Freedom RM, Smallhorn JF (1996) Aortic valve regurgitation after surgical versus percutaneous balloon valvotomy for congenital aortic valve stenosis. Am J Cardiol 77:1332–1338

    Article  CAS  PubMed  Google Scholar 

  15. Karamlou T, Shen I, Alsoufia B, Burch G, Reller M, Silberbach M, Ungerleider RM (2005) The influence of valve physiology on outcome following aortic valvotomy for congenital bicuspid valve in children: 30-year results from a single institution. Eur J Cardiothorac Surg 27:81–85

    Article  PubMed  Google Scholar 

  16. Lababidi Z (1983) Aortic balloon valvuloplasty. Am Heart J 106:751–752

    Article  CAS  PubMed  Google Scholar 

  17. Latiff HA, Sholler GF, Cooper S (2003) Balloon dilatation of aortic stenosis in infants younger than 6 months of age: intermediate outcome. Pediatr Cardiol 24:17–26

    Article  CAS  PubMed  Google Scholar 

  18. Maskatia SA, Ing FF, Justino H, Crystal MA, Mullins CE, Mattamal RJ, O’Brian Smith E, Petit CJ (2011) Twenty-five year experience with balloon aortic valvuloplasty for congenital aortic stenosis. Am J Cardiol 108:1024–1028

    Article  PubMed  Google Scholar 

  19. Maskatia SA, Justino H, Ing FF, Crystal MA, Mattamal RJ, Petit CJ (2013) Aortic valve morphology is associated with outcomes following balloon valvuloplasty for congenital aortic stenosis. Catheter Cardiovasc Interv 81:90–95

    Article  PubMed  Google Scholar 

  20. McCrindle BW (1996) Independent predictors of immediate results of percutaneous balloon aortic valvotomy in children. Valvuloplasty and angioplasty of congenital anomalies (VACA) registry investigators. Am J Cardiol 77:286–293

    Article  CAS  PubMed  Google Scholar 

  21. McCrindle BW, Blackstone EH, Williams WG, Sittiwangkul R, Spray TL, Azakie A, Jonas RA (2001) Are outcomes of surgical versus transcatheter balloon valvotomy equivalent in neonatal critical aortic stenosis? Circulation 104(suppl I):152–158

    Google Scholar 

  22. Pedra CA, Sidhu R, McCrindle BW, Nykanen DG, Justo RN, Freedom RM, Benson LN (2004) Outcomes after balloon dilation of congenital aortic stenosis in children and adolescents. Cardiol Young 14(3):315–321

    Article  PubMed  Google Scholar 

  23. Reich O, Tax P, Marek J, Razek V, Gilik J, Tomek V, Chaloupecky V, Bartakova H, Skovranek J (2004) Long term results of percutaneous balloon valvoplasty of congenital aortic stenosis: independent predictors of outcome. Heart 90:70–76

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Siddiqui J, Brizard CP, Galati JC, Iyengar AJ, Hutchinson D, Konstantinov IE, Wheaton GR, Ramsay JM, d’Udekem Y (2013) Surgical valvotomy and repair for neonatal and infant congenital aortic stenosis achieves better results than interventional catheterisation. J Am Coll Cariol 62:2134–2140

    Article  Google Scholar 

  25. Ten Harkel AD, Berkhout M, Hop WC, Witsenburg M, Helbing WA (2009) Congenital valvular aortic stenosis: limited progression during childhood. Arch Dis Child 94:531–535

    Article  PubMed  Google Scholar 

  26. Thomson JDR (2004) Management of valvar aortic stenosis in children. Heart 90:5–6

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA et al (2003) Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 16:777–802

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest. There is no financial or ethical conflict of interests regarding the contents of the submission.

Author information

Authors and Affiliations

  1. Cardiology Department, Mother and Child Health Institute of Serbia, R. Dakica St. 6-8, 11070, Belgrade, Serbia

    Sergej M. Prijic, Vladislav A. Vukomanovic & Jovan Lj. Kosutic

  2. School of Medicine, University of Belgrade, Dr Subotica St. 8, 11000, Belgrade, Serbia

    Sergej M. Prijic, Vladislav A. Vukomanovic, Mila S. Stajevic, Marija D. Zdravkovic & Jovan Lj. Kosutic

  3. Cardiothoracic Surgery Department, Mother and Child Health Institute of Serbia, R. Dakica St. 6-8, 11070, Belgrade, Serbia

    Mila S. Stajevic & Igor N. Sehic

  4. Pediatric Cardiology Department, Clinical Center Nis, Dr Z. Djindjica Boulevard 48, 18000, Nis, Serbia

    Bojko B. Bjelakovic

  5. School of Medicine, University of Nis, Dr Z. Djindjica Boulevard 81, 18000, Nis, Serbia

    Bojko B. Bjelakovic

  6. Cardiology Department, University Medical Center Bezanijska Kosa, Bezanijska kosa bb, 11000, Belgrade, Serbia

    Marija D. Zdravkovic

Authors
  1. Sergej M. Prijic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vladislav A. Vukomanovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mila S. Stajevic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bojko B. Bjelakovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marija D. Zdravkovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Igor N. Sehic
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jovan Lj. Kosutic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jovan Lj. Kosutic.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Prijic, S.M., Vukomanovic, V.A., Stajevic, M.S. et al. Balloon Dilation and Surgical Valvotomy Comparison in Non-critical Congenital Aortic Valve Stenosis. Pediatr Cardiol 36, 616–624 (2015). https://doi.org/10.1007/s00246-014-1056-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-014-1056-6

Keywords

Search

Navigation