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Hoffmann, R. A wiki for the life sciences where authorship matters. Nature Genetics (2008)

Aortic valve reinterventions after balloon aortic valvuloplasty for congenital aortic stenosis intermediate and late follow-up.

OBJECTIVES: the aim of this study was to evaluate the long-term results of transcatheter balloon aortic valvuloplasty, the preferred treatment for congenital aortic stenosis (AS). BACKGROUND: aortic valve function and reintervention late after this procedure are not well characterized. METHODS: from 1985 to 2008, 563 patients underwent balloon dilation for congenital AS. After excluding those converted to univentricular circulation and/or died ≤ 30 days after the procedure, 509 patients constituted the study cohort. RESULTS: The median follow-up period was 9.3 years (range 0.1 to 23.6 years); cumulative follow-up was 5,003 patient-years. The median age was 2.4 years (range 1 day to 40.5 years), and most patients (73%) had isolated native AS. Peak AS gradients decreased significantly after dilation (median decrease, 35 mm Hg), and acute post-dilation aortic regurgitation was moderate or greater in 70 patients (14%). Older patients more often had post-dilation aortic regurgitation (p < 0.001). During follow-up, 225 patients (44%) underwent aortic valve reintervention: repeat balloon dilation in 115 (23%), aortic valve repair in 65 (13%), and aortic valve replacement in 116 (23%). Survival free from any aortic valve reintervention was 89 ± 1% at 1 year, 72 ± 2% at 5 years, 54 ± 3% at 10 years, and 27 ± 3% at 20 years. Freedom from aortic valve replacement was 90 ± 2% at 5 years, 79 ± 3% at 10 years, and 53 ± 4% at 20 years. In multivariate analyses, lower post-dilation AS gradient and lower grade of post-dilation aortic regurgitation were associated with longer freedom from aortic valve replacement, but age, era, and pre-dilation AS severity were not. CONCLUSIONS: although transcatheter aortic valvuloplasty is effective for relief of congenital AS, there are steady long-term hazards for surgical aortic valve reintervention and replacement that are independent of age at initial intervention or AS severity.[1]


  1. Aortic valve reinterventions after balloon aortic valvuloplasty for congenital aortic stenosis intermediate and late follow-up. Brown, D.W., Dipilato, A.E., Chong, E.C., Lock, J.E., McElhinney, D.B. J. Am. Coll. Cardiol. (2010) [Pubmed]
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