Aortic Valvuloplasty in Pediatric Age

Lim, Hong Gook; Park, Chun Soo; Hwang, Ho Young; Kim, Woong Han; Lee, Jeong Ryul; Kim, Yong Jin; Rho, Joon Ryang

Abstract

BACKGROUND
In this study, we retrospectively analyzed the outcomes of aortic valvuloplasty in pediatric age. MATERIAL AND METHOD: Between January 1993 and March 2004, 35 patients underwent aortic valvuloplasty for aortic stenosis (AS) or aortic regurgitation (AR). The mean age was 81.1+/-61.5 (1~223) months. The mean follow up was 50.8+/-30.2 (3~121) months. Nine patients had AS, 21 had AR, and 6 had AS and AR. Valve morphology was tricuspid in 24 patients, bicuspid in 9, quadricuspid in 1, and unicuspid in 1. The mean peak pressure gradients of AS were 72.0+/-33.0 mmHg, and the mean grades of AR were 3.1+/-0.9. RESULT: There was one late mortality without early mortality. After operation, AS improved with mean peak pressure gradients of 23.5+/-21.0 mmHg (p<0.05), and AR improved with mean grades of 1.9+/-0.8 (p<0.05). At mean follow up of 35.0+/-23.0 months, AS maintained with mean peak pressure gradients of 31.5+/-24.0 mmHg, but AR progressed with mean grades of 2.8+/-1.3 (p<0.05). Reoperation was required in 6 patients 38.3+/-21.8 months after the original operation. The actuarial figures for freedom from reoperation at 2, 5 and 8 years were 96.9+/-3.1%, 79.5+/-5.5%, and 56.8+/-11.4%, respectively. Age at operation, presence of AS, preoperative severity of AS or AR, and morphology of aortic valve were not significant risk factors for reoperation, and improvement of AS or AR.
CONCLUSION
Aortic valvuloplasty showed good immediate postoperative valve function. Aortic valvuloplasty offers children many years with tolerable valve function and allows to postpone aortic valve replacement or Ross procedure in pediatric patients.