- Evaluation of direct and long-term results of balloon valvuloplasty of aortic stenosis in newborns
Evaluation of direct and long-term results of balloon valvuloplasty of aortic stenosis in newborns
SOVREMENNAYA PEDIATRIYA.2018.4(92):65-68; doi 10.15574/SP.2018.92.65
Chornenka I., Maksymenko A., Kuzmenko Y., Kurkevych A.
SI «Scientific and Practical Medical Centre for Paediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine», Kyiv
Balloon valvuloplasty (BVP) can alleviate the symptoms of aortic stenosis (AS) in patients, but this procedure is accompanied by an increased risk of mortality and morbidity and often requires further reintervention. Despite this fact, BVP has no complications associated with the use of cardiopulmonary bypass in newborns, which is particularly undesirable in patients with a severe or decompensated state and unstable haemodynamics.
Objective: to study the results of balloon valvuloplasty in newborns with isolated aortic stenosis.
Material and methods. During the period from 2010 to 2015, BVP were performed at the Centre for Paediatric Cardiology and Cardiac Surgery in 31 newborns as a primary method of correction of isolated AS. The median age was 8 days (from 0 to 27 days), the average weight was 3.4±0.6 kg (from 2.3 to 4.6 kg). Before operation, 29 (93.6%) patients had no aortic valve insufficiency, 1 child (3.22%) had a minimal insufficiency and in 1 case (3.22%) there was a mild aortic insufficiency. The median of the maximum gradient on aortic valve (AV) was 60 mm Hg (from 20 to 140 mm Hg).
Results. The maximum gradient on discharge and in the long-term period remained at the level of 33±13.3 and 37.8±23.7, respectively. Aortic insufficiency (AI) increased significantly during the follow-up period. In the long-term period without insufficiency there was only 1 (3.2%) patient. Hospital mortality was observed in 1 (3.2%) case. The follow-up period for the patients of the study group was 61.2±22.4 months. During this time, 13 (43.3%) patients underwent 17 reoperations on the aortic valve.
Conclusions. Newborns after balloon valvuloplasty are susceptible to significant progression of AI. Within 5 years, 42% of the patients were reoperated. Valve replacement was performed in 16.7% of surviving patients during the follow-up period.
Key words: aortic stenosis, balloon valvuloplasty, newborns.
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