Heart Function and Remodeling after Successful Balloon Valvuloplasty for Congenital Aortic Stenosis in Children

Congenital Aortic Stenosis (AS) is a common problem among congenital heart diseases and balloon valvuloplasty is known as the procedure of choice for treatment.
This study aimed at evaluation of the function and remodeling of the heart after a successful balloon AS valvuloplasty.
Patients and From September 2012 to 2016, 33 patients with congenital AS who had successful balloon valvuloplasty were enrolled into this study. All patients were evaluated by 2D, M-mode, Doppler, and tissue Doppler echocardiography before and after the procedure. The data were analyzed using the SPSS statistical software.
The median duration of follow-up was 2 years (range = 6 months to 7.4 years). Besides, the mean of immediate peak-to-peak gradient reduction was 41.50 ± 17.36 mmHg. Moderate to severe aortic insufficiency occurred in less than 28% of the patients. Additionally, M-mode echocardiography showed residual left ventricular hypertrophy in 50% of the patients. Moreover, E∕A ratio was less than -2 Z-scores in 73% of the patients. E/Ea ratio was also more than 2 Z-scores in 50% of the patients, which was an indicator of diastolic dysfunction. The most common associated lesion was bicuspid aortic valve in 48% of the cases.
Balloon aortic valvuloplasty effectively reduced peak systolic pressure gradient across the aortic valve in patients with congenital AS although left ventricular hypertrophy and diastolic dysfunction persisted in a significant number of patients.