Transluminal balloon valvuloplasty and aortoplasty in the treatment of congenital heart defects
The authors' experience in endovascular treatment of such congenital heart defects as pulmonary valvular stenosis (PVS), aortic valvular stenosis (AVS), and aortic coarctation (AC) is presented. Transluminal balloon dilatation was performed in 46 patients: in 30 patients with PVS, 11 patients with CA, and 4 patients with AVS, the patients' age ranging from 7 months to 45 years. Transluminal balloon valvuloplasty was performed using 'Schneider-Medintag' catheters (Switzerland). In PVS patients, the systolic pressure in the right ventricle (RV) was reduced after the procedure from 129 +/- 10.4 to 58 +/- 3.5 mm Hg, the systolic pressure gradient (SPG) between the right ventricle and pulmonary artery fell from 111 +/- 10.6 to 35 +/- 3.8 mm Hg, and the pulmonary valve opening was enlarged from 13.4 +/- 1.5 to 69 +/- 3.9 mm2. Late (6-18-month) results were studied in 5 patients. In CA and reversed CA patients, the SPG between the ascending and descending aorta was reduced from 47.0 +/- 1.7 to 16.0 +/- 3.7 mm Hg, the coarctation diameter increased from 4.5 +/- 0.6 to 8.2 +/- 2.3 mm. In congenital AVS patients, the SPG between the left ventricle and aorta was reduced from 106.5 +/- 35.1 to 39.5 +/- 8.1 mm Hg. Thus, the transluminal balloon valvuloplasty is an effective therapeutic intervention and might be an alternative to surgical treatment. Further experience will allow one to specify indications to its performance in congenital heart disease.