Repeat balloon dilation of congenital valvar aortic stenosis: Immediate results and midterm outcome

While balloon dilation (BD) has become the initial treatment for congenital valvar aortic stenosis (CVAS) at many institutions, repeat BD for recurren t obstruction has been reported only in a few, Between January 1985 and Dec ember 1996, 298 patients (70 neonates) underwent BD, 34 of whom underwent a repeat BD without mortality, A greater proportion of neonates had a repeat BD (26% vs. 8%, P < 0.001), At repeat BD (1 day-7.5 years post initial BD) , the mean peak-to-peak gradient was reduced from 67 +/- 24 to 36 +/- 16 mm Hg (P < 0.0001). Aortic regurgitation (AR) increased immediately in 26%, b eing moderate or more in 24%, During a mean follow-up of 5.2 years, there w as one surgically related death. Of the 33 survivors, 6 had surgery for res idual stenosis and/or AR. Among the remaining 27 patients, 96% were asympto matic, the peak instantaneous aortic valve Doppler gradient was 50 +/- 15 m m Hg with AR absent in 8%, mild in 62%, and moderate or more in 31%. In con clusion, repeat BD is effective and without mortality, AR was at least mode rate in 24% of patients immediately after a second BD. Repeat BD was more c ommon in patients who underwent the initial BD as neonates, Cathet. Cardiov asc. Intervent. 47:47-51, 1999. (C) 1999 Wiley-Liss, Inc.