[Efficacy of percutaneous balloon aortic valvuloplasty for severe aortic valve stenosis in four infants under three months of age].

OBJECTIVE: To evaluate the outcome of percutaneous balloon aortic valvuloplasty (PBAV) for severe aortic valve stenosis in infants younger than 3 months of age. METHODS: Four infants under the age of 3 months (ranged from 34 to 87 days) underwent PBAV for severe aortic stenosis between June 2010 and March 2011 were included in this study. The weight of infants ranged from 2.8 to 4.8 kg. The peak systolic valve gradient, left ventricular ejection fraction (LVEF) and aortic regurgitation were measured in all patients just before and immediately after balloon dilation respectively. Patients were followed-up up to 1 month after PBAV. RESULTS: The aortic annulus diameter ranged from 7.0 to 8.8 mm. The ratio of balloon to aortic annulus diameter ranged from 0.86 to 1.00. PBAV was successful in all cases. The peak systolic valve gradient measured by Doppler echocardiography was (60.6 ± 15.2) mm Hg (1 mm Hg = 0.133 kPa) and LVEF was (47.6 ± 7.5)% before PBAV. Immediately after PBAV, the peak systolic valve gradient decreased to (29.5 ± 8.0) mm Hg (P < 0.01) and LVEF increased to (52.2 ± 18.9)% (P > 0.05). Two patients experienced significant bradycardia during PBAV and restored normal cardiac rhythm after cardiopulmonary resuscitation. At 1 month after PBAV, the peak systolic valve gradient measured by Doppler echocardiography was (36.5 ± 11.0) mm Hg (P < 0.05 vs. pre-PBAV) and LVEF was (81.0 ± 1.1)% (P < 0.01 vs. pre-PBAV). Only trivial to mild aortic regurgitation was detected post PBAV in the 4 patients. CONCLUSION: PBAV is a feasible palliative procedure for infants with isolated aortic valve stenosis without annular or ventricular hypoplasia.