Balloon valvuloplasty of the aortic valve in children: a surgical view.

The paper by Fratz et al. describes the follow-up of 188 children who had balloon aortic valvuloplasty (AoVP) between 1986 and 2004. Moderate or severe aortic regurgitation occurred more often in the 68 neonates--in whom there was significant early mortality--than in the 120 older children; however, AoVP produced a satisfactory reduction in aortic valve gradient in both groups. Reintervention-free status declined in both groups over time and, at 10 years follow-up, 59% of the neonates and 70% of the older group were intervention free. These results show that AoVP postpones the need for aortic valve surgery and has the advantage of being less invasive than initial surgical valvotomy. AoVP is, however, associated with an increased risk of aortic regurgitation and, in neonates, early subsequent aortic valve surgery is likely to be needed.