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Study for Balloon Aortic Valvuloplasty in Congenital Aortic Stenosis

Journal of the Korean Pediatric Society 2001;44(2):167-176.
Published online February 15, 2001.
Study for Balloon Aortic Valvuloplasty in Congenital Aortic Stenosis
In Seung Park1, Do Jun Cho1, Mi Young Han1, Jae Young Lee1, Soo Jin Kim1, Mee-Hye Oh2, Eun Jung Bae3, Seong Ho Kim4
1Department of Pediatrics, Sejong General Hospital, Pucheon, Korea
2Department of Pediatrics, Sejong General Hospital, Pucheon, Korea
3Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea
4Department of Pediatrics, Gachon Medical University, Incheon, Korea
선천성 대동맥판협착 환아에서의 풍선 대동맥판성형술에 대한 연구
박인승1, 조도준1, 한미영1, 이재영1, 김수진1, 오미혜2, 배은정3, 김성호4
1세종병원 소아과
2세종병원 해부병리과
3서울대학교 의과대학 소아과학교실
4가천의과대학교 소아과학교실
Abstract
Purpose
: The aims of this study are to investigate the results of balloon aortic valvuloplasty (BAV) in congenital aortic stenosis(CAS) and, especially, to compare the results between BAV performed before two months of age(Group A) and BAV after two month of age(Group B).
Methods
: From January 1993 to June 2000, 14 patients who were diagnosed as CAS were treated with BAV. Indications for BAV were 1) critical aortic stenosis and 2) a peak-to-peak systolic pressure gradient in excess of 50mmHg or a gradient ≥40mmHg with either symptoms or EKG changes.
Results
: In Group A, the procedures were performed through femoral artery, carotid, or femoral vein approach. In Group B, however, all procedures were performed through femoral artery approach. After the BAV, a peak-to-peak systolic pressure gradient was reduced from 66.5±31.3 mmHg to 30.1±15.5mmHg(Group A; from 42.3±23.8mmHg to 22.0±15.3mmHg, Group B; from 88.9±16.8mmHg to 38.1±11.5mmHg). Repeated BAV were tried in 3 of these cases. There were 3 mortality cases in Group A. One of them was related with the procedure.
Conclusion
: The result of BAV after 2 months of age is acceptable, but that before 2 months of age is not satisfactory. However this result of BAV on early infants is thought to be mainly related to the poor pre-BAV conditions. So BAV may still be considered as a first intervention for CAS in this period. In such cases, other approachs rather than femoral artery should be considered.
Key Words: Congenital aortic stenosis, Balloon aortic valvuloplasty


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