Aortic Valve Repair in Neonates With Aortic Stenosis and Reduced Left Ventricular Function

Schulz, Antonia; Taylor, Luke; Buratto, Edward; Ivanov, Yaroslav; Zhu, Michael Z.L.; Konstantinov, Igor E.

doi:10.1053/j.semtcvs.2022.07.013

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…Nevertheless, the data on its incidence varied greatly in previous publications. In a recent study involving a cohort of 16 neonates with aortic valve stenosis and LV dysfunction, the distribution of valve morphologies was 68.75% unicuspid, 25% bicuspid, and 6.25% tricuspid, according to the authors [4]. Matsushima et al stated that "almost all" stenotic aortic valves "requiring intervention in childhood" are due to an underlying unicuspid morphology [24].…”

Section: Discussionmentioning

confidence: 99%

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Balloon Valvuloplasty in Congenital Critical Aortic Valve Stenosis in Neonates and Infants: A Rescue Procedure for the Left Ventricle

Pfeifer,

Rentzsch,

Poryo

et al. 2024

JCDD

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Congenital critical aortic valve stenosis (CAVS) is a life-threatening disease requiring urgent treatment. First-line therapy is still controversial. The aim of our study was (1) to analyze retrospectively the patients of our institution who underwent balloon aortic valvuloplasty (BAV) due to CAVS and (2) describe the techniques for improved feasibility of intervention using microcatheters and retrieval loops. Twelve patients underwent 23 BAVs: 1 BAV was performed in 3 patients, 2 BAVs were performed in 7 patients, and 3 BAVs were performed in 2 patients. The peak trans-valvular pressure gradient (Δp) and left ventricular shortening fraction (LVSF) improved significantly in the first two interventions. In the first BAV, Δp decreased from 73.7 ± 34.5 mmHg to 39.8 ± 11.9 mmHg (p = 0.003), and the LVSF improved from 22.3 ± 13.5% to 31.6 ± 10.2% (p = 0.001). In the second BAV, Δp decreased from 73.2 ± 33.3 mmHg to 35.0 ± 20.2 mmHg (p < 0.001), and the LVSF increased from 26.7 ± 9.6% to 33.3 ± 7.4% (p = 0.004). Cardiac surgery during the neonatal period was avoided for all children. The median time to valve surgery was 5.75 years. Few complications occurred, namely mild-to-moderate aortic regurgitation, one remediable air embolism, and one intimal injury to the ascending aorta. We conclude that BAV is a successful emergency treatment for CAVS, resulting in left ventricular relief, clinical stabilization, and a time gain until cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

“…AV dysplasia and hypoplasia of the aortic annulus are the main causes. In most cases, the AV has a unicuspid or bicuspid morphology [2,4] due to congenital commissural fusions. Additional cardiac malformations may exist, such as aortic hypoplasia or coarctation of the aorta.…”

Section: Introductionmentioning

confidence: 99%

Balloon Valvuloplasty in Congenital Critical Aortic Valve Stenosis in Neonates and Infants: A Rescue Procedure for the Left Ventricle

Pfeifer,

Rentzsch,

Poryo

et al. 2024

JCDD

View full text Add to dashboard Cite

show abstract

“…AV dysplasia and hypoplasia of the aortic annulus are the main causes. In most cases, the AV has a unicuspid or bicuspid morphology [2,4] due to congenital commissural fusions. Additional cardiac malformations may exist as for example aortic hypoplasia or coarctation of the aorta.…”

Section: Introductionmentioning

confidence: 99%

Balloon Valvuloplasty In Congenital Critical Aortic Valve Stenosis – A Rescue Procedure For The Left Ventricle

Pfeifer,

Rentzsch,

Poryo

et al. 2024

Preprint

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Critical aortic valve stenosis (CAVS) is a life-threatening cardiac disease of the newborn requiring urgent treatment. First-line therapy is still controversial. The aim of our study was (1) to analyze retrospectively the patients of our institution who underwent balloon aortic valvuloplasty (BAV) due to CAVS, and (2) to describe techniques for improved feasibility of the intervention using microcatheters and retrieval loops. Twelve patients underwent 23 BAVs: 1 BAV was performed in 3 patients, 2 BAVs in 7 patients, and 3 BAVs in 2 patients. Trans-valvular pressure gradient (Δp) and left ventricular shortening fraction (LVSF) improved significantly in the first two interventions; first BAV: Δp from 73.7 ±34.5 mmHg to 39.8 ±11.9 mmHg (p=0.003) and LVSF from 22.3 ± 13.5 % to 31.6 ±10.2 % (p=0.001); second BAV: Δp from 73.2 ±33.3 mmHg to 35.0 ± 20.2 mmHg (p&lt;0.001) and LVSF from 26.7 ±9.6 % to 33.3 ±7.4 % (p=0.004). Cardiac surgery during the neonatal period was avoided for all children; median time to valve surgery was 5.75 years. Few complications occurred: mild to moderate aortic regurgitation, one remediable air embolism, and one intimal injury of the ascending aorta. We conclude that BAV is a successful primary treatment for CAVS resulting in left ventricular relief, stabilization of the neonate, and a time gain until cardiac surgery.

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Optimal timing of Ross operation in children: A moving target?

Konstantinov,

Bacha,

Barron

et al. 2024

The Journal of Thoracic and Cardiovascular Surgery

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Aortic Valve Repair in Neonates With Aortic Stenosis and Reduced Left Ventricular Function

Cited by 4 publications

References 33 publications

Balloon Valvuloplasty in Congenital Critical Aortic Valve Stenosis in Neonates and Infants: A Rescue Procedure for the Left Ventricle

Balloon Valvuloplasty in Congenital Critical Aortic Valve Stenosis in Neonates and Infants: A Rescue Procedure for the Left Ventricle

Balloon Valvuloplasty In Congenital Critical Aortic Valve Stenosis – A Rescue Procedure For The Left Ventricle

Optimal timing of Ross operation in children: A moving target?

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