Key result
Aortic valvuloplasty for congenital aortic valve stenosis in pediatric patients achieved 10-year freedom from aortic valve surgery in 59% of patients <1 month and 70% of patients ≥1 month of age.
Why the study?
Does aortic valvuloplasty postpone the need for aortic valve surgery in pediatric patients with congenital aortic valve stenosis?
Cohort (n=188)
No
Does aortic valvuloplasty postpone the need for aortic valve surgery in pediatric patients with congenital aortic valve stenosis?
Absolute Event Rate: 59% vs 70%
Aortic valvuloplasty is highly effective in postponing aortic valve surgery in pediatric patients with congenital aortic stenosis, with approximately two-thirds remaining surgery-free at 10 years.
May support deferral of valve surgery via valvuloplasty in pediatric aortic stenosis; leaves open need for prospective comparisons of durability.
BACKGROUND: Aortic valvuloplasty (AoVP) is an established procedure regarded as a valid alternative for surgical management of congenital aortic valve stenosis. However, its long-term efficacy in preventing or postponing aortic valve surgery remains uncertain for the individual patient. Therefore, the aim of this study was to study the long-term results of AoVP in pediatric patients and its efficacy in preventing or postponing aortic valve surgery. METHODS AND RESULTS: We reviewed up to 17.5 years of follow-up data of all 188 patients who received AoVP at the Deutsches Herzzentrum München. The patients were divided into those < 1 month of age (group < 1 month; n=68) and those > or = 1 month of age (group > or = 1 month; n=120) at the time of AoVP. After the first and second AoVP, moderate and severe aortic regurgitation developed in 29% and 14%, respectively, of the patients in group < 1 month and in 19% and 29%, respectively, of the patients in group > or = 1 month. Survival after 10 years free from aortic valve surgery was 59% (95% confidence interval, 45 to 73) in group < 1 month and 70% (95% confidence interval, 59 to 81) in group > or = 1 month. CONCLUSIONS: This study shows that the long-term results of AoVP of congenital aortic valve stenosis in pediatric patients and its efficacy in preventing or postponing aortic valve surgery are very good. About two thirds of the patients are free from aortic valve surgery 10 years after AoVP.
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Fratz et al. (2008) conducted a cohort in Congenital aortic valve stenosis (n=188). Aortic valvuloplasty (< 1 month of age) vs. Aortic valvuloplasty (≥ 1 month of age) was evaluated on Survival after 10 years free from aortic valve surgery. Aortic valvuloplasty for congenital aortic valve stenosis in pediatric patients achieved 10-year freedom from aortic valve surgery in 59% of patients <1 month and 70% of patients ≥1 month of age.
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