Long-term results of balloon aortic valvulotomy for congenital aortic stenosis in children and adolescents

Background and aim of the study: The aim of the study was to report on the long-term results of aortic valve balloon dilatation (AVBD) for congenital valvular aortic stenosis in children and young adults. Methods: The records of 74 patients (age range: 1-20 years) who underwent AVBD at a single center were analyzed retrospectively. Special attention was paid to factors that might influence long-term outcome. Results: The procedure was successful in 71 patients (96%). The mean (+/- SD) reduction in peak-to-peak systolic gradient (PSG) was 68.7 +/- 13.5%. No patient required immediate surgical intervention. Survival after dilatation was 100% at 12 years. At follow up (mean 5.5 +/- 2.9 years; range: 2-12 years), 20% of patients had restenosis and 21% had significant aortic regurgitation (AR) (grade greater than or equal to 3). Reintervention was performed in 14% of patients. Severity of AR and high residual stenosis immediately after AVBD were associated with the late event rates. The actuarial intervention-free rates at five, seven and 12 years were 92.9%, 84.4% and 60%, respectively. Conclusion: AVBD is a useful, albeit palliative, procedure for children and young adults with significant congenital valvular aortic stenosis.