Why the study?
For children with congenital aortic stenosis eligible for biventricular repair, valvuloplasty can be performed surgically or via transcatheter balloon dilation, but longer term comparative outcomes warranted evaluation.
Does surgical aortic valvuloplasty improve long-term outcomes compared to balloon aortic dilation in pediatric patients with congenital aortic stenosis?
Does surgical aortic valvuloplasty improve long-term outcomes compared to balloon aortic dilation in pediatric patients with congenital aortic stenosis?
Surgical aortic valvuloplasty provides greater gradient reduction, less aortic insufficiency, and lower 10-year reintervention rates compared to balloon dilation for pediatric congenital aortic stenosis.
SAV may be considered over BAD in pediatric congenital AS; leaves open need for randomized confirmation before practice change.
BACKGROUND: For children with congenital aortic stenosis (AS) who are candidates for biventricular repair, valvuloplasty can be achieved by surgical aortic valvuloplasty (SAV) or by transcatheter balloon aortic dilation (BAD). We aimed to evaluate the longer term outcomes of SAV versus BAD at our institution. METHODS: We retrospectively reviewed the outcomes of 2 months to 18 years old patients who underwent SAV or BAD at our institution between January 1990 and July 2018. Baseline and follow-up characteristics were assessed by echocardiography. Long-term survival, freedom from reintervention, freedom from aortic valve replacement (AVR), and aortic regurgitation were evaluated. CONCLUSIONS: Surgical aortic valvuloplasty demonstrated greater gradient reduction, less postoperative and long-term AI, and a lower reintervention rate at 10 years than BAD. There was no difference in survival or AVR reintervention rate. Surgical aortic valvuloplasty is a durable and efficacious intervention and should continue to be considered a favorable choice for palliation of valvular AS.
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Herrmann et al. (2020) studied this question.
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