Long-Term Clinical Follow-Up Results in Patients with Pediatric Valvular Aortic Stenosis: A Single Center Experience

Öz

Objective: This study aimed to evaluate the long-term clinical outcomes of pediatric patients with valvular aortic stenosis (VAS) treated at a single tertiary center, with a focus on the efficacy and safety of balloon aortic valvuloplasty (BAV). Materials and Methods: A total of 450 pediatric patients diagnosed with VAS between 2001 and 2023 were retrospectively reviewed. Clinical, echocardiographic, and angiographic data were analyzed. Among these, 130 patients who underwent BAV for moderate-to-severe or critical stenosis were evaluated in detail. Hemodynamic changes, procedural complications, development of aortic regurgitation (AR), and reintervention rates were recorded. Results: The cohort had a mean age of 120.6 ± 55.8 months, and 74.5% were male. The mean follow-up duration was 5.2 years (range: 1–17 years). The bicuspid aortic valve was the most common morphology (75.5%). Among the 130 patients who underwent balloon aortic valvuloplasty (BAV), the age at angiography was <1 month in 27.6%, 1–12 months in 16.9%, 12–60 months in 16.1%, 60–120 months in 20.7%, and >120 months in 15.3% of cases. BAV resulted in a significant reduction in left ventricular pressure (from 171.6 to 135.2 mmHg) and systolic gradient (from 83.9 to 32.3 mmHg). AR developed in 84.6% of patients post BAV, but only 2.5% had severe regurgitation. Repeat BAV was required in 10.7% of patients, and 3.2% were referred for surgical intervention. Four neonates with critical of and pre-existing LV dysfunction died. Conclusion: BAV is an effective and minimally invasive intervention for pediatric VAS, offering substantial short- to mid-term relief from obstruction. However, the risks of AR and reintervention warrant careful patient selection and long-term follow-up.

Anahtar Kelimeler

• Valvular aortic stenosis
• balloon valvuloplasty
• follow-up

Kaynakça

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