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Title: Immediate and follow-up results of transluminal balloon dilation for discrete subaortic stenosis
Authors: Suárez de Lezo, José María
Pan, Manuel
Medina, Alfonso
Romero, Miguel
Melián, Francisco
Segura, José
Hernández, Enrique
Pavlovic, Djordje
Morales, Juan
Vivancos, Ricardo
Ramón Ortega, José
UNESCO Clasification: 320501 Cardiología
Keywords: Subvalvular Aortic-Stenosis
Issue Date: 1991
Journal: Journal of the American College of Cardiology 
Abstract: This study presents the findings in 33 patients with discrete subaortic stenosis who were treated by percutaneous balloon dilation and were followed up for 2 months to 6.2 years (mean 34 +/- 21 months). The mean age was 13 +/- 11 years; 10 (30%) were female and 23 (70%) male. Associated malformations were observed in nine patients (27%). All patients underwent noninvasive studies and cardiac catheterization. The mean valve to membrane distance was 4.5 +/- 2 mm/m2.After balloon dilation, the pressure gradient from the left ventricle to the aorta decreased from 68 +/- 30 to 20 +/- 13 mm Hg (p < 0.00001); there were no significant changes in the degree of aortic regurgitation. A fluttering and widely mobile remaining membrane was clearly visualized after dilation. Better immediate results were obtained in patients with a smaller baseline gradient, a larger aortic anulus and a longer valve to membrane distance.Serial follow-up echographic studies were available in 30 patients, and 18 hemodynamic reevaluations were performed in 13 patients. However, seven patients who demonstrated restenosis underwent redilation at a mean of 29 +/- 17 months after the first dilation. Redilation in six of the seven patients obtained benefits similar to those observed at the first dilation. Only one patient with unsuccessful redilation required surgery. The mean value of the last explored residual gradient (on hemodynamic or Doppler study) in the remaining 32 patients was 21 +/- 10 mm Hg. No significant changes were observed in the angiographic evolution of aortic regurgitation.In conclusion, percutaneous balloon dilation may be a useful complement to surgical therapy in patients with a thin discrete subaortic stenosis. However, close follow-up is needed.
ISSN: 0735-1097
DOI: 10.1016/0735-1097(91)90553-L
Source: Journal of the American College of Cardiology [ISSN 0735-1097], v. 18 (5), p. 1309-1315, (Noviembre 1991)
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