Abstract 13375: Persistent, Long-Term Decline In Two-Dimensional Strain Echocardiography Findings After Balloon Valvulotomy in Children With Congenital Valvar Aortic Stenosis
Aims: To investigate the recovery of systolic myocardial function with 2DSTE after balloon valvulotomy for severe congenital valvar aortic stenosis (VAS) in children.
METHODS: 37 children with severe, isolated VAS were included prospectively. Patients underwent echocardiographic evaluation: prior to valvulotomy, 6 months after intervention, and at late follow-up (3.4 ± 0.7 years after intervention). Longitudinal, circumferential and radial peak systolic strain (S), -rate (Sr), and time to S (T2P). Linear mixed models were employed to assess the change in 2DSTE parameters after intervention. With One Way ANOVA, late follow-up 2DSTE results were compared with 2DSTE measurements in: (1) 74 healthy age-matched children (2) 76 children with uncorrected VAS whose severity of stenosis corresponded with residual VAS of study subjects at late follow-up.
RESULTS: S and Sr results in all three directions were decreased prior to intervention as compared to healthy children. S and Sr increased significantly (P<0.001) several months after balloon valvulotomy and continued to increase at 3 years follow-up. However, at late follow up, S and Sr were still significantly (P<0.001) lower when compared to both control groups. T2P results were significantly shorter at early follow-up when compared to values prior to intervention (P<0.05).
Conclusion: After balloon valvulotomy for severe congenital VAS there is an improvement in systolic myocardial deformation. However, 2DSTE parameters do not return to normal at late follow-up. These abnormalities in systolic deformation cannot be fully attributed to residual stenosis, and are possibly indicative of irreversible myocardial damage.
- © 2011 by American Heart Association, Inc.