Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery · 2025
Immediate and long-term results of balloon aortic valvuloplasty for critical aortic valve stenosis in newborns. A single-center experience.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Rączka Marek, Kuźma Jacek, Król Wanda, Weryński Piotr, Rudziński Andrzej, Skalski Janusz Hieronim, Góreczny Sebastian
Аннотация
INTRODUCTION: Newborns with critical aortic valve stenosis (AVS) constitute a challenging group of patients, requiring urgent treatment, which in most centers is currently transcatheter balloon aortic valvuloplasty (BAV).
AIM: Assessment the immediate and long-term outcome of BAV in newborns including preterm infants with critical AVS.
MATERIAL AND METHODS: We analyzed retrospectively 28 neonates (including 7 preterm infants) with critical AVS treated with the BAV procedure at mean age of 12.1 days. The mean follow-up period was 6.4 years. Patients were divided into 2 groups depending on the left ventricle ejection fraction (LVEF) ≤ 40% - group I (n = 12 patients, including 5 preterm infants) and > 40% - group II (n = 16 patients, including 2 prematures).
RESULTS: In both groups, the peak transvalvular pressure gradient across the aortic valve (TAPG) decreased significantly after BAV, whereas the mean LVEF increased significantly only in group I newborns. Various adverse events occurred in 6 (21.4%) newborns. A total of 12 (42.8%) children required re-intervention, including 1 child who underwent 3 procedures. They occurred slightly more often in children born prematurely (57.1%) compared to children born at term (38%). During follow-up, 6 patients died, 5 patients in group I and 1 in group II, including 3 of 7 preterm infants (all in group I). The Kaplan-Meier survival curve showed significantly higher mortality in group I patients (p = 0.03).
CONCLUSIONS: BAV as the initial treatment for newborns with critical AVS gives satisfactory results, but further follow-up shows a frequent need for re-intervention. Significant LV systolic dysfunction and prematurity are risk factors for higher mortality in these patients.
AIM: Assessment the immediate and long-term outcome of BAV in newborns including preterm infants with critical AVS.
MATERIAL AND METHODS: We analyzed retrospectively 28 neonates (including 7 preterm infants) with critical AVS treated with the BAV procedure at mean age of 12.1 days. The mean follow-up period was 6.4 years. Patients were divided into 2 groups depending on the left ventricle ejection fraction (LVEF) ≤ 40% - group I (n = 12 patients, including 5 preterm infants) and > 40% - group II (n = 16 patients, including 2 prematures).
RESULTS: In both groups, the peak transvalvular pressure gradient across the aortic valve (TAPG) decreased significantly after BAV, whereas the mean LVEF increased significantly only in group I newborns. Various adverse events occurred in 6 (21.4%) newborns. A total of 12 (42.8%) children required re-intervention, including 1 child who underwent 3 procedures. They occurred slightly more often in children born prematurely (57.1%) compared to children born at term (38%). During follow-up, 6 patients died, 5 patients in group I and 1 in group II, including 3 of 7 preterm infants (all in group I). The Kaplan-Meier survival curve showed significantly higher mortality in group I patients (p = 0.03).
CONCLUSIONS: BAV as the initial treatment for newborns with critical AVS gives satisfactory results, but further follow-up shows a frequent need for re-intervention. Significant LV systolic dysfunction and prematurity are risk factors for higher mortality in these patients.