Doğan Eser, Levent Ertürk
Pediatric Cardiology, Ege University, Izmir, TUR.
Cureus. 2024 Jul 15;16(7):e64547. doi: 10.7759/cureus.64547. eCollection 2024 Jul.
Congenital aortic stenosis is a common pathology in the childhood age group and its clinical spectrum varies between asymptomatic and severe heart failure. In our study, we planned to evaluate the long-term results of patients who underwent balloon aortic valvuloplasty (BAV) due to critical aortic valve stenosis in our clinic.
Patients aged 0-18 years who underwent aortic balloon valvuloplasty due to aortic stenosis in our clinic between January 2002 and January 2022 were retrospectively evaluated.
Among the 48 patients who underwent balloon valvuloplasty due to aortic stenosis, 13 (27%) were female, and 35 (73%) were male. The median age at the time of the procedure was 27.5 months (IQR: 4-96), the median weight was 9.9 kg (IQR: 5.40-29.50), and the median height was 79 cm (IQR: 54-133). The median follow-up duration was 93.5 months (IQR: 38-132). Angiographic assessments in all patients revealed a median left ventricular pressure of 160 mmHg (IQR: 140-200) and a median pressure gradient between the left ventricle and the aorta of 60 mmHg (IQR: 42-80). The median balloon diameter used was 10 mm (IQR: 8-12). Post-procedural measurements showed a median mean gradient of 30 mmHg (IQR: 20-35) between the left ventricle and the aorta. The procedure was successful in 45 (93.5%) patients. During follow-up, 11 patients required surgical intervention. Ross procedure was performed in five patients, homograft in five patients, and mechanical valve implantation in one patient. Risk factors for the need for surgical intervention were evaluated in detail. During the follow-up, the risk factor for intervention was determined to be aortic insufficiency.
Aortic valve balloon valvuloplasty is a safe and successful treatment method for critical aortic stenosis. It should be the first choice of treatment option in suitable patients.
先天性主动脉瓣狭窄是儿童年龄组常见的病理状况，其临床谱在无症状和严重心力衰竭之间有所不同。在我们的研究中，我们计划评估因严重主动脉瓣狭窄在我们诊所接受球囊主动脉瓣成形术（BAV）的患者的长期结果。
对2002年1月至2022年1月期间在我们诊所因主动脉瓣狭窄接受主动脉球囊瓣膜成形术的0至18岁患者进行回顾性评估。
在因主动脉瓣狭窄接受球囊瓣膜成形术的48例患者中，13例（27%）为女性，35例（73%）为男性。手术时的中位年龄为27.5个月（四分位间距：4 - 9），中位体重为9.9千克（四分位间距：5.40 - 29.50），中位身高为79厘米（四分位间距：54 - 133）。中位随访时间为93.5个月（四分位间距：38 - 132）。所有患者的血管造影评估显示左心室压力中位数为160 mmHg（四分位间距：140 - 200），左心室与主动脉之间的压力梯度中位数为60 mmHg（四分位间距：42 - 80）。使用的球囊直径中位数为10毫米（四分位间距：8 - 12）。术后测量显示左心室与主动脉之间的平均梯度中位数为30 mmHg（四分位间距：20 - 35）。该手术在45例（93.5%）患者中成功。在随访期间，11例患者需要手术干预。5例患者进行了罗斯手术，5例患者进行了同种异体移植，1例患者进行了机械瓣膜植入。详细评估了手术干预的危险因素。在随访期间，确定干预的危险因素为主动脉瓣关闭不全。
主动脉瓣球囊瓣膜成形术是治疗严重主动脉瓣狭窄的一种安全且成功的治疗方法。在合适的患者中应作为首选治疗方案。
