SIX YEARS EXPERIENCE OF TRANSCATHETER RELIEF OF CONGENITAL AORTIC VALVE STENOSIS IN PAEDIATRIC POPULATION AT ARMED FORCES INSTITUTE OF CARDIOLOGY RAWALPINDI

Abstract

Objective: To determine the efficacy and safety of transcatheter balloon valvuloplasty in severe aortic stenosis in paediatric population.

Study Design: Observational study.

Place and Duration of Study: Catheterization lab at armed forces institute of cardiology, national institute of health Rawalpindi, from Jan 2011 to Dec 2016.

Material and Methods: All patients having age 1-12 years, who underwent balloon dilatation of severe aortic valve stenosis, were registered in the registry kept at catheterization laboratory. Complete patient profile, echocardiographic findings and pre and post balloon valvuloplasty findings were recorded. Procedure was considered successful if invasive gradient across aortic valve was reduced to less than 50% of original. The data
was analyzed using SPSS version 23.

Results: A total of 75 patients undergone aortic balloon valvuloplasty during study period with mean age of 5.3 ± 3.3 years. All patients undergoing the procedure had severe aortic valve stenosis with the mean echo derived pressure gradient (PG) across the aortic valve of 70 ± 28 mmHg. The mean invasive PG across the aortic valve before and after balloon valvuloplasty was 71 ± 29 mmHg Vs. 22 ± 15 mm of Hg (p-value <0.001). Procedure was successful in 72 cases (96%) while three patients had suboptimal result. Post valvuloplasty 8 patients (10.6%) patient had mild AR. No patients developed sever AR, pericardial effusion and mortality was found to be zero percent.

Conclusion: We conclude that balloon valvuloplasty is a safe and effective procedure with minimum complications in patients with isolated severe aortic stenosis.