Efficacy of percutaneous balloon aortic valvuloplasty for severe aortic valve stenosis in four infants under three months of age
10.3760/cma.j.issn.0253-3758.2012.04.006
- VernacularTitle:经皮球囊主动脉瓣成形术治疗小婴儿重症主动脉瓣狭窄的疗效观察
- Author:
Li-Jun FU
1
;
Ai-Qing ZHOU
;
Ying GUO
;
Peng-Jun ZHAO
;
Fen LI
Author Information
1. 上海交通大学医学院附属新华医院(上海儿童医学中心)
- Keywords:
Aortic valve stenosis;
Infant;
Heart catheterization
- From:
Chinese Journal of Cardiology
2012;40(4):289-292
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the outcome of percutaneous balloon aortic valvuloplasty (PBAV) for severe aortic valve stenosis in infants younger than 3 months of age.Methods Four infants under the age of 3 months (ranged from 34 to 87 days) underwent PBAV for severe aortic stenosis between June 2010 and March 2011 were included in this study.The weight of infants ranged from 2.8 to 4.8 kg.The peak systolic valve gradient,left ventricular ejection fraction (LVEF) and aortic regurgitation were measured in all patients just before and immediately after balloon dilation respectively. Patients were followed-up up to 1 montb after PBAV.Results The aortic annulus diameter ranged from 7.0 to 8.8 mm.The ratio of balloon to aortic annulus diameter ranged from 0.86 to 1.00.PBAV was successful in all cases.The peak systolic valve gradient measured by Doppler echocardiography was (60.6 ± 15.2) mm Hg (1mm Hg =0.133 kPa) and LVEF was (47.6 ± 7.5)％ before PBAV. Immediately after PBAV,the peak systolic valve gradient decreased to (29.5 ± 8.0) mm Hg (P＜0.01 ) and LVEF increased to (52.2±18.9)％ (P＞0.05).Two patients experienced significant bradycardia during PBAV and restored normal cardiac rhythm after cardiopulmonary resuscitation.At 1 month after PBAV,the peak systolic valve gradient measured by Doppler echocardiography was (36.5 ± 11.0) mm Hg(P＜0.05 vs.pre-PBAV) and LVEF was (81.0 ± 1.1 )％ (P＜0.01 vs.pre-PBAV).Only trivial to mild aortic regurgitation was detected post PBAV in the 4 patients.Conclusion PBAV is a feasible palliative procedure for infants with isolated aortic valve stenosis without annular or ventricular hypoplasia.
