Yenduri Naimisha, Sasikumar Navaneetha, Patel Asha, Kumar Raman Krishna
Department of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Ann Pediatr Cardiol. 2024 Jul-Aug;17(4):277-280. doi: 10.4103/apc.apc_103_24. Epub 2024 Nov 15.
We hypothesized that a double-balloon technique would be associated with a lower likelihood of aortic regurgitation (AR) following balloon aortic valvotomy (BAV). We present the short- and mid-term outcomes of the double-balloon technique for BAV. Fifty consecutive patients (median age: 6.5 years; interquartile range (IQR): 3.8-13.2) underwent BAV using double balloons. Prior AR was present in 17 (34%). Following BAV, the peak-to-peak gradient reduced from 80 (66.5-100) mm Hg to 24 (16-35) mm Hg ( < 0.0001); 10 (20%) had trivial AR, 18 (36%) had mild AR, 10 (20%) had moderate AR and none had severe AR. Four (8%) had transient arterial occlusion requiring anticoagulation. There was no procedure-related mortality or requirement for emergency open-heart surgery. The double-balloon technique offers a safe and effective alternative option for BAV in patients beyond infancy with relatively large annulus sizes. There is a low likelihood of postprocedural severe AR and the need for repeat procedures. Further long-term follow-up of this cohort is needed to ascertain long-term outcomes.
我们假设，在球囊主动脉瓣切开术（BAV）后，双球囊技术与主动脉瓣反流（AR）可能性较低相关。我们展示了BAV双球囊技术的短期和中期结果。连续50例患者（中位年龄：6.5岁；四分位间距（IQR）：3.8 - 13.2）接受了双球囊BAV。17例（34%）术前存在AR。BAV后，跨瓣压差从80（66.5 - 100）mmHg降至24（16 - 35）mmHg（<0.0001）；10例（20%）有微量AR，18例（36%）有轻度AR，10例（20%）有中度AR，无重度AR。4例（8%）发生短暂性动脉闭塞，需要抗凝治疗。无手术相关死亡或急诊心脏直视手术需求。双球囊技术为婴儿期后且瓣环相对较大的患者进行BAV提供了一种安全有效的替代选择。术后发生重度AR及需要重复手术的可能性较低。需要对该队列进行进一步长期随访以确定长期结果。
