Surgical valvotomy versus balloon dilatation for children with severe aortic valve stenosis: a systematic review

• Published in: Future cardiology Vol. 18; no. 11; pp. 901 - 913
• Main Authors: Elhedai, Huzeifa, S Mohamed, Salma Saeed, Idriss, Hamid, Bhattacharya, Pratik, Y Mohamedahmed, Ali Yasen
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.11.2022
• Subjects: aortic regurgitation; aortic stenosis; Aortic Valve - surgery; Aortic Valve Insufficiency; Aortic Valve Stenosis - surgery; balloon aortic dilatation; Catheterization; Child; Dilatation; Humans; mortality; reduction of aortic systolic gradient; surgical aortic valvotomy; Treatment Outcome; mortality; balloon aortic dilatation; aortic regurgitation; aortic stenosis; reduction of aortic systolic gradient; surgical aortic valvotomy
• ISSN: 1479-6678; 1744-8298
• DOI: 10.2217/fca-2022-0053

To evaluate outcomes of interventions for severe aortic valve stenosis (AS), whether it is done by surgical aortic valvotomy (SAV) or balloon aortic dilatation (BAD). Eleven studies with total number of 1733 patients; 743 patients had SAV, while 990 patients received BAD. There was no significant difference in early mortality (odds ratio [OR]: 0.96, p = 0.86), late mortality (OR: 1.28, p = 0.25), total mortality (OR: 1.10, p = 0.56), and freedom from aortic valve replacement (OR: 1.00, p = 1.00). Reduction of aortic systolic gradient was significantly higher in the SAV group (OR: 2.24, p = 0.00001), and postprocedural AR rate was lower in SAV group (OR: 0.21, p = 0.00001). SAV is associated with better reduction of aortic systolic gradient and lesser post procedural AR which reduce when compared with BAD. Congenital aortic valve stenosis is disease in which in which babies are born with narrowing of their aortic valve (the valve leading to main body artery). This study aims to evaluate best outcomes for the two main interventions to treat this disease which are; balloon dilatation (keyhole) and open-heart surgery. Our study results showed that there was no significant difference in mortality between the two treatment strategies; however, there is better immediate results in reliving valve narrowing after and less valve leak after open heart surgery than after key hole procedure. These results remain operator dependent and can differ between centers; therefore, more high-quality studies are encouraged to determine best treatment option for aortic stenosis.