AORTIC VALVOTOMY VERSUS BALLOON DILATATION IN PEDIATRIC AGE - MIDDLE TERM FOLLOW-UP RESULTS

In order to compare the therapeutic usefulness of the two techniques, 20 patients with congenital valvular aortic stenosis that had undergone valvotomy (group I) or balloon dilatation (group II) were studied by echo-Doppler; particularly the mean pressure gradient, the aortic valvular area indexed to body surface area (AVAI) and the degree of valvular regurgitation were assessed. The two groups were comparable for: a) stenosis degree; b) no significant valvular dysplasia; c) follow-up > 2.5 years. Group I included 10 patients (8 M-2 F) aged 13 months to 13 years (mean 5.2 +/- 3.3 years) with maximum systolic gradient ranged from 80 to 100 mmHg (mean 90.6 +/- 3.7) and no aortic regurgitation. Group II included 10 patients (7 M-3 F) aged 4 to 10 years (mean 9.3 +/- 0.8) with maximum systolic gradient ranged from 44 to 155 mmHg (mean 81.2 +/- 12.6) and trivial aortic regurgitation in 2 patients. In the postsurgical or balloon dilatation follow-up the aortic mean pressure gradient ranged from 14 to 63 mmHg (mean 38.6 +/- 16.8) in group I and from 7 to 55 mmHg (mean 23.1 +/- 14.7) in group II (p > 0,05); furthermore all patients of group I with a more significant stenosis had a longer follow-up (> 5 years). The AVAI ranged from 0.64 to 1.42 cm2/m2 (mean 0.81 +/- 0.24) in group I and from 0.66 to 2.00 (mean 1.06 +/- 0.39) in group II (p = n.s.). Aortic regurgitation was showed in 4 patients (2 mild, 2 moderate) in group I and in 6 patients (3 mild, 3 moderate) in group II. In conclusion our result suggest: a) overlap of the therapeutic usefulness of the two techniques in the middle term follow-up; b) follow-up length-ratio of restenosis relationship in patients undergone aortic valvotomy.