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You are here: Contents > 2018 > Volume 27 Number 1 January 2018 > AORTIC VALVE DISEASE > Immediate and Long-Term Follow Up Results of Balloon Aortic Valvuloplasty in Congenital Bicuspid Aortic Valve Stenosis Among Young Patients

Immediate and Long-Term Follow Up Results of Balloon Aortic Valvuloplasty in Congenital Bicuspid Aortic Valve Stenosis Among Young Patients

Ajith Ananthakrishna Pillai1,2, Vidhyakar Rangaswamy Balasubramanian1, Devendra Kanshilal Sharma1

1Department of Cardiology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, India
2Electronic correspondence: ajithanantha@yahoo.com

Background and aim of the study: The study aim was to investigate the immediate and long-term results of balloon aortic valvuloplasty (BAV) in young patients (aged ≤20 years) with congenital bicuspid aortic valve presenting with severe aortic stenosis.

Methods: The study involved a single tertiary care center-based retrospective data analysis of immediate and long-term outcomes in patients following balloon valvuloplasty between 2000 and 2011. A total of 92 young patients (mean age 12.7 years; 95% CI 8.3-16.7 years) with aortic stenosis due to congenital bicuspid aortic valve and who underwent BAV were studied.

Results: The mean follow up period was 5.7 ± 1.3 years. Intervention resulted in successful BAV (≥50% reduction in baseline gradient) in 79 patients (85.9%; group A) and partially successful BAV (<50% reduction in baseline gradient) in eight patients (8.7%; group B). BAV failed in five patients (5.4%; group C). The mean left ventricular systolic pressure was decreased from 155.6 mmHg (95% CI 132.7-186.3 mmHg) to


100.9 mmHg (95% CI 82.1-119.6 mmHg; p <0.001), and the mean aortic valve gradient from 40.7 mmHg (95% CI 25.12-56.22 mmHg) to 17.2 mmHg (95% CI 15.83- 21.23 mmHg; p <0.001). Mean changes in aortic valve area and mean gradient were significantly different between successful BAV groups (A and B) and the failed BAV group (p = 0.001). Different grades of aortic regurgitation were noted in 32 patients (34.78%) after BAV (severe regurgitation in 2.18%). A post hoc analysis showed sustained gradient reductions at one- and five-year follow up investigations (p <0.05). The need for surgery was much lower in the successful BAV groups.

Conclusions: The success of BAV in bicuspid aortic valve stenosis in younger patients was approximately 85%. Although 10% of patients developed re-stenosis and required surgical intervention, the majority did well during the follow up period. It was concluded that BAV is a viable option in adolescents and young children with bicuspid aortic valve without severe calcification.

The Journal of Heart Valve Disease 2018;27:17-23


Immediate and Long-Term Follow Up Results of Balloon Aortic Valvuloplasty in Congenital Bicuspid Aortic Valve Stenosis Among Young Patients

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