CONTEMPORARY RESULTS OF BALLOON VALVULOPLASTY AND SURGICAL VALVOTOMY FOR CONGENITAL AORTIC-STENOSIS

The purpose of this study was to compare contemporary results of ballo on dilatation and surgery for valvar aortic stenosis in infants and ch ildren in the five years between August 1988 and October 1993. Thirty four children underwent attempted balloon valvuloplasty (age 1 day-16 years, weight 1720 g-68 kg) (group 1), eight of whom were neonates wit h critical aortic stenosis. During the same 17 children underwent dire ct valvotomy (group 2) (seven neonates). Successful balloon valvulopla sty was achieved in 33 (97%) with immediate reduction in the instantan eous systolic pressure gradient from 82 to 34 mm Hg (mean). There were two deaths in this group (both neonates), the second in a preterm neo nate hom necrotising enterocolitis. Complications requiring interventi on in group 1 were aortic regurgitation in one and femoral artery inju ry in two. Follow up from four months to five years showed sustained r esults in most cases. There were two neonatal deaths in the surgical g roup. When the two groups were compared there was no significant diffe rence in mortality, morbidity, or need for reintervention within 12 mo nths. Deaths from both groups were attributed to small left ventricles . Hospital stay was significantly shorter in group 1.