Key result
Percutaneous aortic valvoplasty decreases the initial systolic peak-to-peak gradient by ~131 mmHg.
Why the study?
Immediate and midterm results of percutaneous aortic valvoplasty in congenital aortic valvar stenosis were evaluated to address outcomes and limitations in a large Latin-American cohort.
Does percutaneous aortic valvoplasty reduce systolic peak-to-peak gradient and prevent need for reintervention in patients with congenital aortic valvar stenosis?
Cohort (n=141)
No
Does percutaneous aortic valvoplasty reduce systolic peak-to-peak gradient and prevent need for reintervention in patients with congenital aortic valvar stenosis?
p-value: p=> 0.01
Percutaneous aortic valvoplasty provides significant immediate reduction in systolic gradient and acceptable midterm freedom from reintervention in patients with congenital aortic stenosis.
Supports immediate gradient relief in congenital aortic stenosis; extends Level 3 data but leaves open randomized confirmation of durability.
AbstractObjective: To evaluate immediate and midterm results with percutaneous aortic valvoplasty.Material and Methods: We reviewed the records of 141 patients undergoing percutaneous aortic valvopasty over a period of 13 years.Results: The patients were aged from 2 months to 40 years, with a mean of 10.9 ± 9.9 years. Of the total, 90 (63%) were male. The initial systolic peak-to-peak gradient decreased from 163 ± 52 mmHg to 32 ± 18 mmHg (p > 0.01) after valvoplasty in all 141 patients, while the proportional reduction ranged from 0 to 100%, with a mean of 72 ± 27%. The index of the size of the balloon to the diameter of the valvar orifice was 0.88 ± 0.19 in 128 patients. The follow-up ranged from 6 to 168 months, with a mean 51 ± 48 months in 70 patients. A significant difference was found in those failing after dilation when the initial evaluation was compared to the final evaluation of patients with follow-up. In those failing, the number of patients rose from 12 (17%) to 21 (30%) (p > 0.01). In contrast, in those in whom we achieved success, there was not such a great difference between the initial and final evaluation: 58 (83%) versus 49 (70%) (p > 0.1). The actuarial freedom curve of patients not needing new percutaneous aortic valvoplasty or surgery, by 182 months, was at 87% and 82% respectively.Conclusion: We have reviewed the largest series of patients in Latin-America reported thus far after undergoing percutaneous aortic valvoplasty, concentrating on mid term follow-up and limitations. New prospective and multicentric studies are needed from our region.
No takes yet. Share an insight, caveat, or question.
Alva et al. (2002) conducted a cohort in Congenital aortic valvar stenosis (n=141). Percutaneous aortic valvoplasty was evaluated on Systolic peak-to-peak gradient reduction (p=> 0.01). Percutaneous aortic valvoplasty decreased the initial systolic peak-to-peak gradient from 163 ± 52 mmHg to 32 ± 18 mmHg (p > 0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: