Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome

Filip Tyc; Michal Galeczka; Jacek Białkowski; Katarzyna Kulig; Roland Fiszer

doi:10.5114/aic.2022.118532

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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abstract:

Original paper

Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome

Filip Tyc

¹

,

Michal Galeczka

¹

,

Jacek Białkowski

¹

,

Katarzyna Kulig

¹

,

Roland Fiszer

¹

Department of Congenital Heart Defects and Paediatric Cardiology, FMS in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland

Adv Interv Cardiol 2022; 18, 2 (68): 154–161

DOI: https://doi.org/10.5114/aic.2022.118532

Online publish date: 2022/08/19

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AMA

Tyc F, Galeczka M, Białkowski J, Kulig K, Fiszer R. Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2022;18(2):154-161. doi:10.5114/aic.2022.118532.

APA

Tyc, F., Galeczka, M., Białkowski, J., Kulig, K.,  & Fiszer, R. (2022). Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 18(2), 154-161. https://doi.org/10.5114/aic.2022.118532

Chicago

Tyc, Filip, Michal Galeczka, Jacek Białkowski, Katarzyna Kulig,  and Roland Fiszer. 2022. "Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 18 (2): 154-161. doi:10.5114/aic.2022.118532.

Harvard

Tyc, F., Galeczka, M., Białkowski, J., Kulig, K.,  and Fiszer, R. (2022). Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 18(2), pp.154-161. https://doi.org/10.5114/aic.2022.118532

MLA

Tyc, Filip et al. "Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 18, no. 2, 2022, pp. 154-161. doi:10.5114/aic.2022.118532.

Vancouver

Tyc F, Galeczka M, Białkowski J, Kulig K, Fiszer R. Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2022;18(2):154-161. doi:10.5114/aic.2022.118532.

Introduction
Balloon aortic valvuloplasty (BAV) is a common treatment method of aortic valve (AV) stenosis in neonates. Long-term BAV effects are suboptimal, and their predictors are not well acknowledged. Aim: To identify predictors of suboptimal short- and long-term BAV results.

Material and methods
The study group comprised forty-three neonates (8 females; weight 3.34 ±0.56 kg) who underwent BAV between 1998 and 2021. Seventeen patients (39.53%) had critical AV stenosis. AV was bicuspid in 22 patients, tricuspid in 12, unicuspid in 2, and undefined in 7 patients. The mean balloon/annulus ratio was 0.9 ±0.07. Catheterization, clinical, and follow-up data were analysed.

Results
The peak-to-peak gradient decreased from 67.5 ±26.3 to 21.3 ±12.6 mm Hg. Twenty-eight patients (65.1%) had adequate early outcome. Aortic regurgitation (AR) occurred in 13 (30.2%) patients. No predictors of inadequate early outcome were found. Twenty-year survival was 90.7%. Eleven (35.5%) patients underwent reintervention at a median of 12 (1–215) months; BAV in 5 patients, surgical valvuloplasty in 2, Ross operation in 2, AV replacement in 1, and Norwood operation in 1 patient. Fifteen-year freedom from reintervention (FFR) was 48%. Adequate early outcome resulted in higher FFR (71% vs. 22%), and so did no significant AR (60% vs. 30%).

Conclusions
BAV provides satisfying early results. AR remains a significant aftermath of BAV. Risk factors and procedural techniques improving the outcome of BAV are unclear. Further research is needed to improve FFR.

keywords:

Balloon aortic valvuloplasty in neonates: short- and long-term effects and predictors of successful outcome

Filip Tyc 1 , Michal Galeczka 1 , Jacek Białkowski 1 , Katarzyna Kulig 1 , Roland Fiszer 1

congenital aortic stenosis, neonates, balloon valvuloplasty, transcatheter treatment, clinical outcome

Filip Tyc

¹

,

Michal Galeczka

¹

,

Jacek Białkowski

¹

,

Katarzyna Kulig

¹

,

Roland Fiszer

¹