Abstract
Background For patients with congenital aortic valve stenosis (AVS), comprehensive analysis
of surgical aortic valvuloplasty (SAV) or balloon dilation (BD) is scarce and remains
controversial.
Methods This study reviewed AVS data (aortic peak gradient, aortic insufficiency, and survival
and reoperation) for patients who were suitable for biventricular repair at our center
in 2008 to 2018. Patients were categorized into two subgroups based on age (≤3 or
>3 months).
Results A total of 194 patients were treated, including 124 with SAV and 70 with BD. Resulting
data revealed that residual aortic gradient at discharge was worse for BD (p = 0.001). While for patients younger than 3 months, the relief of AVS was comparable
between the two groups (p = 0.624). There was no significant difference in time-related survival between the
two groups (log-rank p = 0.644). Multivariate analysis demonstrated that preoperative left ventricular end-diastolic
dimension predicted early death (p = 0.045). Survival in the two groups after 10 years was 96.8% in SAV and 95.7% in
BD (p = 0.644). Freedom from reoperation after 10 years was 58.1% in SAV and 41.8% in BD
patients (p = 0.01). There was no significant difference in freedom from reoperation between
SAV and BD in patients younger than 3 months (p = 0.84). Multivariate analysis indicated that residual aortic peak gradient was predictive
of reoperation (p = 0.038).
Conclusion Both methods achieved excellent survival outcomes at our center. SAV achieved superior
gradient reduction and minimized the necessity for reoperation. For patients younger
than 3 months, BD rivaled SAV both in aortic stenosis relief and freedom from reoperation.
Keywords
aortic valve and root - cardiac - congenital heart disease
