Conflict of interest: Nothing to report.
Pediatric and Congenital Heart Disease
Aortic valve morphology is associated with outcomes following balloon valvuloplasty for congenital aortic stenosis†
Article first published online: 8 OCT 2012
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 81, Issue 1, pages 90–95, 1 January 2013
How to Cite
Maskatia, S. A., Justino, H., Ing, F. F., Crystal, M. A., Mattamal, R. J. and Petit, C. J. (2013), Aortic valve morphology is associated with outcomes following balloon valvuloplasty for congenital aortic stenosis. Cathet. Cardiovasc. Intervent., 81: 90–95. doi: 10.1002/ccd.24286
- Issue published online: 21 DEC 2012
- Article first published online: 8 OCT 2012
- Manuscript Accepted: 7 DEC 2011
- Manuscript Received: 10 AUG 2011
- pediatric interventions;
- valvular heart disease;
- congenital heart disease in adults
Evaluate the incidence of various morphologic types of congenital AS, and the association between valve morphology and long-term outcomes, including repeat BAV, AVR, and death/transplant.
Reports on long-term outcomes have low agreement on the influence of morphologic type.
We queried our institutional database and hospital billing records to identify all patients who underwent balloon aortic valvuloplasty (BAV) from 1992 through 2009. We excluded cases where morphology was not clear based on the description in the pre-BAV echocardiogram report and patients who underwent single ventricle palliation. The primary outcome of the study was the occurrence of any of the following events: repeat valvuloplasty, AVR, heart transplant, or death.
There were 147 patients in our study cohort. The most common morphology was functionally bicuspid (n = 92, 63%), followed by functionally unicuspid (n = 20, 14%), dysplastic (n = 16, 11%), true bicuspid (n = 13, 9%), and true unicuspid (n = 6, 4%). The primary endpoint was less likely to occur in patients with functionally bicuspid valves (P < 0.01) and patients with true bicuspid valves (P = 0.03), whereas it was more likely to occur in patients with functionally unicuspid valves (P = 0.02) and patients with true unicuspid valves (P = 0.05). Multivariate Cox regression analysis demonstrated that valve type other than functionally bicuspid was associated with diminished freedom from repeat intervention, death or transplant (HR 3.3, CI 1.2 – 8.6, P = 0.02).
In our cohort, patients with functionally bicuspid aortic valves, the most common type, had improved outcomes as compared with all other morphologic types. © 2012 Wiley Periodicals, Inc.