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Long-term results of percutaneous balloon valvuloplasty of congenital aortic stenosis in adolescents and young adults.

作者信息

Awasthy Neeraj, Garg Ria, Radhakrishnan S, Shrivastava Savitri

机构信息

Consultant, Department of Pediatrics and Congenital Heart Diseases, Fortis Escorts Heart Institute, Okhla road, Delhi 110025, India.

Fellow Department of Cardiology, Fortis Escorts Heart Institute, Okhla road, Delhi 110025, India.

出版信息

Indian Heart J. 2016 Sep-Oct;68(5):604-611. doi: 10.1016/j.ihj.2016.03.001. Epub 2016 Mar 30.


DOI:10.1016/j.ihj.2016.03.001
PMID:27773397
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5079125/
Abstract

UNLABELLED: Balloon aortic valvuloplasty (BAV) is a well accepted modality of treatment in congenital aortic stenosis in all age groups. Although in infants and children it is the modality of choice, in adolescents and young adults, it is of debatable efficacy. AIM: To evaluate long-term results of aortic valvuloplasty particularly in adolescent and adults (>12 years) and compare the outcome in other age groups that are <1 year and between 1 are 11 years. SETTING: Tertiary referral center. PATIENTS: 165 consecutive patients treated at the median age of 9 years (1 day to 64 years). The follow-up was up to 14 years (median 3 years). The whole cohort was divided into 3 age-based subgroups: Group A (<1 year) n=45, Group B (1 year-11 years) n=52, and Group C (>12 years) n=68. The characteristics of each subgroup were mutually compared. INTERVENTION: Percutaneous balloon valvuloplasty with mean (SD) balloon to annulus ratio of 0.93. Main outcome measures were repeat BAV, significant aortic regurgitation (AR), and aortic valve replacement/repair. RESULTS: The incidence of significant AR from the whole cohort was 9.9% (8% moderate, 1.9% severe); n=16. Group A=significant AR 9.5% (7.1% moderate, 2.4% severe), Group B=significant AR 11.3% (9.4% moderate, 1.9% severe), and Group C=significant AR 9% (7.5% moderate, 1.5% severe); p value=0.99 (Group C vs Group A) and 0.92 (Group C vs Group B). Repeat BAV rate was 13.3% (n=22 out of 165 patients). Group A - n=5 (11.9%), Group B - n=10 (18.2%), and Group C - n=7 (10.3%). p Value=0.78 (C vs A) and 0.19 (C vs B). Surgery in follow-up was needed in n=4 (2.4%), none in Group A, 2 patients in Group B (3.6%), and 2 patients in group C (2.9%). Patients were followed up for a period of 14 years; Group A=up to 8 years, Group B=up to 13 years, and Group C=up to 14 years. Mean survival probability after the procedure was 8 years (Group A=6.5 years, Group B=8.1 years, and Group C=9.9 years), and p value=0.49 (A vs B), 0.23 (B vs C), and 0.4 (A vs C). CONCLUSION: There is no statistical difference in the long-term outcome in the adults and adolescents as compared to the children; thus BAV remains an obvious treatment of choice with good long-term outcome.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5079125/e752685bf887/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5079125/2b1578cdf93d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5079125/e752685bf887/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5079125/2b1578cdf93d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c55/5079125/e752685bf887/gr2.jpg

相似文献

[1]
Long-term results of percutaneous balloon valvuloplasty of congenital aortic stenosis in adolescents and young adults.

Indian Heart J. 2016

[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
[Balloon valvuloplasty for congenital aortic valve stenosis in children].

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[10]
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引用本文的文献

[1]
Catheter-Based Interventions for the Management of Valvular Heart Disease During Pregnancy.

JACC Adv. 2022-4-27

[2]
Trajectory of Left Ventricular Remodeling in Children With Valvar Aortic Stenosis Following Balloon Aortic Valvuloplasty.

Circ Cardiovasc Imaging. 2022-1

[3]
Balloon Valvuloplasty for Congenital Aortic Stenosis: Experience at a Tertiary Center in a Developing Country.

J Interv Cardiol. 2021

[4]
Surgery for Young Adults With Aortic Valve Disease not Amenable to Repair.

Front Surg. 2018-3-2

[5]
Balloon aortic valvuloplasty.

Indian Heart J. 2016

本文引用的文献

[1]
Aortic balloon valvuloplasty and severe systolic dysfunction. Is there a danger zone?

Catheter Cardiovasc Interv. 2014-11-1

[2]
Balloon aortic valvuloplasty (BAV) as a bridge to aortic valve replacement in cancer patients who require urgent non-cardiac surgery.

Radiol Oncol. 2014-1-22

[3]
Balloon aortic valvuloplasty in the era of transcatheter aortic valve replacement: acute and long-term outcomes.

Am Heart J. 2013-11-4

[4]
Balloon aortic valvuloplasty in high risk aortic stenosis patients with left ventricular ejection fractions <20%.

Catheter Cardiovasc Interv. 2014-11-1

[5]
Left ventricular end-diastolic pressure as an independent predictor of outcome during balloon aortic valvuloplasty.

Catheter Cardiovasc Interv. 2014-4-1

[6]
Balloon Valvuloplasty of Aortic Valve Stenosis in Childhood: Midterm Results in a Children's Hospital, Mansoura University, Egypt.

Clin Med Insights Cardiol. 2012

[7]
Twenty-five year experience with balloon aortic valvuloplasty for congenital aortic stenosis.

Am J Cardiol. 2011-7-24

[8]
Use of a low-profile, compliant balloon for percutaneous aortic valvuloplasty.

Catheter Cardiovasc Interv. 2010-4-1

[9]
Impact of rapid ventricular pacing during percutaneous balloon aortic valvuloplasty in patients with critical aortic stenosis: should we be using it?

Catheter Cardiovasc Interv. 2010-2-15

[10]
Balloon aortic valvuloplasty in adults--a 10-year review of Auckland's experience.

Heart Lung Circ. 2008-12

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