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.

The aim of the present study was to identify predictors of reintervention (surgery or catheterization) after BAV of neonatal aortic stenosis.

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.

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.

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.