Heart Function and Remodeling after Successful Balloon Valvuloplasty for Congenital Aortic Stenosis in Children

Background: Congenital Aortic Stenosis (AS) is a common problem among congenital heart diseases and balloon valvuloplasty is known as the procedure of choice for treatment. Objectives: This study aimed at evaluation of the function and remodeling of the heart after a successful balloon AS valvuloplasty. Patients and Methods: From September 2012 to 2016، 33 patients with congenital AS who had successful balloon valvuloplasty were enrolled into this study. All patients were evaluated by 2D، M-mode، Doppler، and tissue Doppler echocardiography before and after the procedure. The data were analyzed using the SPSS statistical software. Results: The median duration of follow-up was 2 years (range = 6 months to 7.4 years). Besides، the mean of immediate peak-to-peak gradient reduction was 41.50 ± 17.36 mmHg. Moderate to severe aortic insufficiency occurred in less than 28% of the patients. Additionally، M-mode echocardiography showed residual left ventricular hypertrophy in 50% of the patients. Moreover، E∕A ratio was less than -2 Z-scores in 73% of the patients. E/Ea ratio was also more than 2 Z-scores in 50% of the patients، which was an indicator of diastolic dysfunction. The most common associated lesion was bicuspid aortic valve in 48% of the cases. Conclusions: Balloon aortic valvuloplasty effectively reduced peak systolic pressure gradient across the aortic valve in patients with congenital AS although left ventricular hypertrophy and diastolic dysfunction persisted in a significant number of patients.