Long-term results of percutaneous balloon aortic valvuloplasty in children with aortic stenosis: a single-center experience

Abstract

Background: Percutaneous balloon aortic valvuloplasty (BAV) is an effective method of treatment for aortic stenosis in children.

Aims: This study aimed to assess the long‑term results of BAV in various age groups in the pediatric population.

Methods: This retrospective study included 68 patients (newborns, infants, and children older than 1 year). We analyzed their demographic data and measurements performed with the use of cardiac catheterization, angiography, and echocardiography at 3 time points: before, directly after, and at late follow‑up after BAV, including the invasive aortic valve peak‑to‑peak systolic pressure gradient (PGpeak), maximum systolic pressure gradient (PGmax) by Doppler echocardiography, and the severity of aortic regurgitation (AR). Long‑‑term follow‑up data were available for 57 patients.

Results: The BAV procedure led to a significant reduction in the PGpeak values. Late follow‑up revealed a progression of AR. Aortic regurgitation of grade 2 or higher directly after BAV was the strongest risk factor for severe AR at late follow‑up. After 5, 10, and 18 years after BAV, surgical treatment was not required in 90%, 77%, and 59.5% of patients, respectively. Severe AR and a residual PG less than 35 mm Hg at late follow‑up were stronger risk factors for aortic valve surgery than moderate AR and PG higher than or equal to 35 mm Hg.

Conclusions: Balloon aortic valvuloplasty is an effective method of treatment for aortic stenosis in children, which delays the need for surgery. The progression of AR occurs at late follow‑up. A greater reduction in PGmax is a risk factor for at least moderate AR directly after BAV, which results in the progression of AR at late follow‑up.