Key result
Balloon valvuloplasty and surgical valvotomy comparably reduced pressure gradients (P>0.05), but balloon valvuloplasty resulted in lower rates of aortic valve replacement (4.1% vs 20%).
Why the study?
Congenital valvular aortic stenosis represents 3%–6% of congenital heart diseases, and the study aimed to compare outcomes of balloon valvuloplasty and surgical valvotomy.
Does balloon valvuloplasty compared to surgical valvotomy improve clinical and hemodynamic outcomes in pediatric patients with congenital valvular aortic stenosis?
Cohort (n=69)
No
Does balloon valvuloplasty compared to surgical valvotomy improve clinical and hemodynamic outcomes in pediatric patients with congenital valvular aortic stenosis?
Balloon valvuloplasty and surgical valvotomy offer comparable hemodynamic improvements in pediatric congenital aortic stenosis, but balloon valvuloplasty is associated with lower rates of subsequent aortic valve replacement and fewer complications.
Balloon valvuloplasty was associated with fewer subsequent replacements; leaves open preferred initial approach pending randomized trials.
Introduction: Congenital valvular aortic stenosis (AS) represents 3%–6% of congenital heart diseases. This study aimed to compare the outcomes of balloon valvuloplasty (BV) and surgical valvotomy (SV) in patients with AS. Methods: This retrospective study was conducted on 69 patients. A retrospective analysis was done on 69 patients (who underwent BV or SV) at a tertiary heart center in Mashhad, Iran (between 2000 and 2023). Results: The mean age of BV patients ( n = 24, 17 males) was 67.08 ± 55.92 months, while it was 97.44 ± 64.18 months in SV patients ( n = 45, 33 males). Both treatments reduced the pressure gradients without significant differences ( P > 0.05). Aortic valve replacement (AVR) was performed in 20% of SV and 4.1% of BV patients. Over 60% remained intervention-free for at least 5 years. Moderate-to-severe aortic insufficiency developed in 19% of SV and 7% of BV patients. A second-time SV was required in 6.7% and 4.2% of SV and BV cases, respectively. Conclusion: BV and SV showed comparable outcomes, with BV demonstrating shorter hospitalization, fewer complications, and lower AVR rates, though reintervention remained necessary for both.
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Tosi et al. (2026) conducted a cohort in Congenital valvular aortic stenosis (n=69). Balloon valvuloplasty vs. Surgical valvotomy was evaluated on Reduction in pressure gradients (p=> 0.05). Balloon valvuloplasty and surgical valvotomy comparably reduced pressure gradients (P>0.05), but balloon valvuloplasty resulted in lower rates of aortic valve replacement (4.1% vs 20%).
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