Long-Term Outcomes of Percutaneous Balloon Aortic Valvuloplasty: Experience in Single Tertiary Center
Chayamon Suwansumrit, MD¹,², Khwaunrat Whaidee, MD¹,³, Navaporn Phiphattanatikanunt, MD¹,³, Pornthep Lertsapchareon, MD¹,³
Affiliation : ¹ Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; ² Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand; ³ Cardiac Center, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand
Background: Percutaneous balloon aortic valvuloplasty (PBAV) has been introduced as a first-line treatment for congenital aortic valvular stenosis. However, complications such as residual valvular stenosis and valvular regurgitation can occur following PBAV, requiring re-intervention or surgery.
Materials and Methods: The present study was a retrospective descriptive study that enrolled 34 patients under the age of 18 with a diagnosis of aortic valvular stenosis who underwent PBAV between 2003 and 2023. Medical records, including patients’ demographic data, clinical presentations, echocardiographic reports, and cardiac catheterization reports, were reviewed, collected, and analyzed.
Results: Median pre-procedural peak-to-peak systolic pressure gradient (PSG) between left ventricle and aorta was 57 mmHg (IQR 39 to 88) and decreased to the median PSG of 15 mmHg (IQR 10 to 28) after the procedure. Median decremental rate of PSG after procedure in overall patients was 74.3%. A significant association was found between the high reduction rate of PSG and the severity of aortic regurgitation (AR) (p=0.03). Median follow-up time was 35.6 months (range 7.4 to 66.9). At the last follow-up, half of the patients had more than moderate AR. Freedom from moderate and severe AR was 85.5% at one year and 64.3% at five years post-procedure. Overall re-intervention-free rate was 94.1% at one year and 75% at five years.
Conclusion: PBAV is an effective and safe treatment for congenital aortic stenosis, resulting in a high survival rate. However, it carries long-term risks of aortic valvular dysfunction, restenosis, and significant regurgitation, often leading to re-intervention. Balancing the minimization of residual stenosis and the avoidance of significant regurgitation is crucial for achieving a favorable long-term outcome.
Received 29 September 2025 | Revised 23 January 2026 | Accepted 28 January 2026
DOI: 10.35755/jmedassocthai.2026.4.03679
Keywords : Aortic stenosis; Percutaneous balloon aortic valvuloplasty; Aortic regurgitation
All Articles
Download
