Balloon dilation and surgical valvotomy comparison in non-critical congenital aortic valve stenosis.

Abstract

Percutaneous balloon aortic valvoplasty (BAV) and surgical aortic valvotomy (SAV) are palliative procedures in patients with non-critical congenital valve stenosis. The aim of the study was to evaluate long-term BAV and SAV results after up to 24years of follow-up. From 1987 to 2013, 74 consecutive interventions were performed in patients with aortic stenosis, and 62 were included in the study (39 BAVs and 23 SAVs). Age of BAV patients was 1.3months to 17years, and of SAV patients 1.2months to 15years. Although BAV patients were older, there was no difference between groups according to sex, valve function/morphology, and early/late follow-up results, with exception to hospitalization period. Significant pressure gradient reduction and aortic regurgitation increment were registered after procedures. Three patients did not survive early period after surgery. Follow-up period was 7.0±5.4 and 9.0±8.0years after BAV and SAV, respectively (p=0.242). Follow-up pressure gradient rose only in the BAV group, and was emphasized after 10-year-follow-up (p=0.020). Significant aortic insufficiency progression was registered after 15years of follow-up in both groups (p=0.007 and p=0.009, respectively). Mean reintervention-free survival was 12.0years in the BAV and 14.5years in the SAV group (p=0.733), and mean survival without aortic valve replacement was 15.2 and 17.4years, respectively (p=0.877). BAV and SAV in patients with congenital aortic stenosis are very comparable in both early and late follow-up results.