Balloon dilatation of critical neonatal aortic stenosis: Predictive factors of reintervention - 14/08/18
Résumé |
Background |
Balloon aortic valvulopasty (BAV) is an alternative therapy to surgery in newborns with critical aortic stenosis and has become the first-line treatment in many centers. Concerns remain as to restenosis, aortic valve regurgitation and risks of reintervention.
Aims |
The aim of the present study was to identify predictors of reintervention (surgery or catheterization) after BAV of neonatal aortic stenosis.
Methods |
Monocentric, retrospective study. Thirty-six neonates with congenital aortic valve stenosis, who underwent BAV, were included between 10-2003 and 11-2016. Patients were divided into 2 groups [group 1:<15 days (n=23), group 2:>15 days (n=13)]. Median follow-up reached 3 [1–9] years. Immediate success was defined as residual aortic valve gradient<35mmHg and absence of significant aortic regurgitation.
Results |
Median age at intervention was 8 [1–45] days, median weight 3.4 [1.1–5.4] kg. Median balloon/annulus ratio was 1 [0.8–1.2]. Post-procedure mortality was 11%. Procedure was successful in 23 patients (71.9%). Freedom from reintervention was 78% at 1 year and 62.5% at 5 years. Age<15 days and presence of a significant residual gradient (>35mmHg at the end of the catheterization or on Doppler at the end of the hospitalization) were significantly associated with reintervention (P=0.001 and P=0.013, respectively). The balloon/annulus ratio was not significantly associated with reintervention.
Conclusion |
BAV remains a valuable alternative to surgical valvotomy in neonatal aortic valve stenosis. Age of the patients and residual gradient were in our study, significantly associated with risk of reintervention.
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Vol 10 - N° 3-4
P. 288 - septembre 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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