Percutaneous aortic valvoplasty in congenital aortic valvar stenosis

OBJECTIVE: 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.