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Long term results of percutaneous balloon valvoplasty of congenital aortic stenosis: independent predictors of outcome
  1. O Reich,
  2. P Tax,
  3. J Marek,
  4. V Rázek,
  5. J Gilík,
  6. V Tomek,
  7. V Chaloupecký,
  8. H Bartáková,
  9. J Škovránek
  1. Kardiocentrum, University Hospital Motol, Prague, Czech Republic
  1. Correspondence to:
    Dr O Reich
    Kardiocentrum, University Hospital Motol, V úvalu 84, Prague 150 06, Czech Republic;


Objective: To evaluate long term results and independent predictors of outcome of aortic valvoplasty.

Design: Retrospective follow up study. Independent predictors of outcome identified by multiple logistic regression.

Setting: Tertiary referral centre.

Patients: 269 consecutive patients treated at the median age of 8 months (0–23 years): 80 (30%) under 4 weeks, 59 (22%) between 4 weeks and 1 year, and 130 (48%) over 1 year. The follow up period was up to 14.8 years (median 5.3, in survivors 6.4 years).

Interventions: Percutaneous balloon valvoplasty with mean (SD) balloon to annulus ratio 0.97 (0.08).

Main outcome measures: Restenosis ⩾ 70 mm Hg, grade 3 aortic insufficiency, cusps disruption, surgery, death, and valvoplasty failure (significant restenosis or insufficiency or surgery or death).

Results: The mortality rate was 10.4% (n  =  28), the restenosis rate was 16.7% (n = 45), significant insufficiency developed in 22.3% (n = 60), surgery was needed in 20.1% (n = 54), and “valvoplasty failure” occurred in 41.6% (n  =  112) patients. Mean (SEM) survival probability 14.4 years after the procedure was 0.89 (0.02) and mean (SEM) probability of surgery-free survival was 0.50 (0.08). The independent predictors were as follows. For restenosis: small aortic annulus; for cusp disruption: large aortic annulus; for insufficiency: bicuspid aortic valve; for need for surgery: bicuspid aortic valve; for death: small aortic annulus, low left ventricular shortening fraction, and low sequential number of the valvoplasty; and for valvoplasty failure: small aortic annulus, bicuspid aortic valve, and high grade of mitral insufficiency.

Conclusion: Independent predictors of unfavourable outcome are small aortic annulus, bicuspid aortic valve, poor function of left ventricle or mitral valve, and limited operator experience.

  • aortic stenosis
  • children
  • heart catheterisation
  • interventions

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