Congenital severe aortic stenosis with congestive heart failure in late childhood and adolescence: Effect on left ventricular function after balloon valvuloplasty

Autor: A. K. Saxena, R.C. Jindal, Savitri Shrivastava, Kothari Ss, Rajnish Juneja
Rok vydání: 2000
Předmět:
Zdroj: Catheterization and Cardiovascular Interventions. 51:168-172
ISSN: 1522-726X
1522-1946
DOI: 10.1002/1522-726x(200010)51:2<168::aid-ccd7>3.0.co;2-c
Popis: Left ventricular (LV) dysfunction with congestive heart failure (CHF) resulting from severe congenital aortic stenosis (AS) is a well-described condition in infancy, but it is rarely found in older children and adolescents. Aortic valve surgery in such cases may be associated with higher rates of morbidity and mortality. Aortic valve balloon dilatation (AVBD) is a viable alternative, but its effect on LV function has not been evaluated. We describe follow-up results of AVBD in 10 cases of severe congenital AS in older children and adolescents with CHF and LV dysfunction. The ages of these patients ranged from 5 to 18 yr (mean ± SD: 10.8 ± 4 yr), and nine were males. The follow-up period after AVBD ranged from 3 mo to 7 yr (mean ± SD: 2.93 ± 2.1 yr). Success was achieved in all cases, with no immediate complications. After valvuloplasty, the peak-to-peak systolic gradient declined from 74.7 ± 30.8 to 33.9 ± 18.2 mm Hg (P 60 mm Hg in five cases on follow-up. Two of these patients underwent another AVBD successfully 4 and 16 mo later, respectively. Aortic valve replacement was done in two patients, one for severe restenosis with mild AR 12 mo after AVBD and another for severe re-restenosis with moderate AR 21 mo after a second AVBD. Severe congenital AS can be associated with LV dysfunction and CHF in late childhood and adolescence. AVBD results in good palliation with improvement in LV function on follow-up. Cathet. Cardiovasc. Intervent. 51:168–172, 2000. © 2000 Wiley-Liss, Inc.
Databáze: OpenAIRE
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