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Brain & Heart

PERSPECTIVE ARTICLE
Pictorial rendition of author’s observations on

balloon valvuloplasty/angioplasty procedures:
Aortic stenosis

P. Syamasundar Rao*

Children’s Heart Institute, University of Texas-Houston McGovern Medical School, Children’s
Memorial Hermann Hospital, Houston, Texas, United States of America

Abstract

Balloon aortic valvuloplasty (BAV) effectively decreases peak pressure gradients
through the aortic valve both at the time of the procedure and during follow-up. This
paper presents the author’s observations on the utility of BAV in treating congenital
aortic valve stenosis (AVS). Previous work by the author noted intermediate-term
restenosis and late-onset aortic insufficiency (AI). Factors contributing to restenosis
include age under 3 years and post-balloon residual aortic valve gradients exceeding
30 mmHg. Repeat balloon valvuloplasty has been found to address restenosis
effectively. However, the onset of AI at late follow-up is a significant disadvantage
of BAV. Despite this, BAV is currently considered a beneficial treatment option for
managing AVS in children, adolescents, and young adults. In contrast, seniors with
calcific AVS do not experience relief from obstruction with BAV and are candidates
for aortic valve replacement through transcatheter methodology, a procedure not
reviewed in this paper. BAV provides relief of obstruction across the aortic valve and
functions as an alternative to surgical intervention. Consequently, BAV is considered
*Corresponding author:
P. Syamasundar Rao a preferred choice in addressing aortic stenosis in the pediatric patient.
(p.syamasundar.rao@uth.tmc.edu)
Citation: Rao PS. Pictorial rendition Keywords: Aortic stenosis; Balloon aortic valvuloplasty; Restenosis; Aortic insufficiency
of author’s observations on
balloon valvuloplasty/angioplasty
procedures: Aortic stenosis. Brain &
Heart. 2024;2(3):2914.
doi: 10.36922/bh.2914 1. Introduction
Received: February 11, 2024 Following a brief description of the historical aspects of transcatheter interventional
Accepted: June 21, 2024 procedures, a pictorial rendition of the author’s published studies on balloon dilatation
of pulmonary valve obstruction has been presented in a prior publication. In this paper,
1
Published Online: July 25, 2024
a pictorial rendition of the author’s studies on balloon aortic valvuloplasty (BAV) for
Copyright: © 2024 Author(s). aortic valve stenosis (AVS) is described.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution 2. Congenital AVS
License, permitting distribution,
2-6
and reproduction in any medium, The technique developed by Dotter, Grüntzig, and their associates was employed
7,8
provided the original work is by Lababidi et al. to treat AVS. Following this development, BAV became the initial
properly cited. therapy of choice for treating congenital AVS. 9-11 The indications for BAV are analogous
Publisher’s Note: AccScience to those employed for surgical intervention, namely aortic valve peak pressure gradients
Publishing remains neutral with higher than 70 mmHg or a gradient higher than 50 mmHg, along with symptoms and/
regard to jurisdictional claims in 9-12
published maps and institutional or ST-T wave abnormalities. In this section, the technique and results of BAV to treat
affiliations. valvar AVS are reviewed.
Volume 2 Issue 3 (2024) 1 doi: 10.36922/bh.2914