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(Circulation. 2008;117:1201-1206.)
© 2008 American Heart Association, Inc.

Valvular Heart Disease

Aortic Valvuloplasty in Pediatric Patients Substantially Postpones the Need for Aortic Valve Surgery

A Single-Center Experience of 188 Patients After up to 17.5 Years of Follow-Up

Sohrab Fratz, MD; Hans Peter Gildein, MD; Gunter Balling, MD; Walter Sebening, MD; Thomas Genz, MD; Andreas Eicken, MD; John Hess, MD

From the Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Klinik an der Technischen Universität München, Munich, Germany.

Correspondence to Sohrab Fratz, MD, Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Klinik an der Technischen Universität München, Lazarettstrasse 36, 80636 Munich, Germany. E-mail fratz{at}dhm.mhn.de

Received January 4, 2007; accepted December 7, 2007.

Background— Aortic valvuloplasty (AoVP) is an established procedure regarded as a valid alternative for surgical management of congenital aortic valve stenosis. However, its long-term efficacy in preventing or postponing aortic valve surgery remains uncertain for the individual patient. Therefore, the aim of this study was to study the long-term results of AoVP in pediatric patients and its efficacy in preventing or postponing aortic valve surgery.

Methods and Results— We reviewed up to 17.5 years of follow-up data of all 188 patients who received AoVP at the Deutsches Herzzentrum München. The patients were divided into those <1 month of age (group <1 month; n=68) and those 1 month of age (group 1 month; n=120) at the time of AoVP. After the first and second AoVP, moderate and severe aortic regurgitation developed in 29% and 14%, respectively, of the patients in group <1 month and in 19% and 29%, respectively, of the patients in group 1 month. Survival after 10 years free from aortic valve surgery was 59% (95% confidence interval, 45 to 73) in group <1 month and 70% (95% confidence interval, 59 to 81) in group 1 month.

Conclusions— This study shows that the long-term results of AoVP of congenital aortic valve stenosis in pediatric patients and its efficacy in preventing or postponing aortic valve surgery are very good. About two thirds of the patients are free from aortic valve surgery 10 years after AoVP.

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CLINICAL PERSPECTIVE

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Clinical Summaries
Circulation 2008 117: 1121-1123. [Full Text]