Progress of interventional therapy of congenital valvular aortic stenosis

Abstract

Congenital valvular aortic stenosis(AS), which refers to a congenital malformation of the aortic valve, is the most common causes of left ventricular outflow tract obstruction in children.In 1983, percutaneous balloon aortic valvuloplasty (PBAV) was firstly described as the treatment for congenital AS in children.Over the past 30 years advancement in technique and equipment had radically improved the safety and outcome of balloon valvuloplasty of aortic valve.Nowadays the technique is widely regarded as the therapy of first choice for children with congenital AS.However, it is essential to make decisions about treatment and define which approach has the best chance of success for any given patient before the initial intervention, especially for the neonate with critical AS.PBAV is usually effective for acutely relieving left ventricular outflow obstruction and has excellent short term results in most children with congenital AS.The mid-and long-term outcome after a successful balloon dilation of congenital AS in childhood is also good, but late restenosis and valve regurgitation eventually necessitate reintervention in the majority of children, which included aortic valve replacement.PBAV was found to have a high incidence of complications and remains one of the most challenging procedures in the interventional therapy of congenital heart disease.Operators should not only acquire the necessary manual skills, but also have the ability to make sound clinical judgment and deal with critical events.Owing to its palliative nature of balloon dilation for congenital AS, the follow-up care of patients after procedure is quite important. Key words: Valvular aortic stenosis, congenital; Balloon aortic valvuloplasty; Child