Retrecissement valvulaire aortique congenital avec dysfonction ventriculaire gauche: effet de la dilatation percutanee

ABSTRACT

Two girls aged 6 ans 1 5 years with severe congenital valvular aortic stenosis and left ventricular [LV] dysfunction underwent successful balloon aortic valvotomy [BAV]. Both patients had severe symptoms at the time of initial evaluation. The electrocardiograms showed LV hypertrophy and cardiac enlargement [cardiothoracic ratio 0,7 and 0,65] was evident in the chest roentgenograms. Immediately after BAV, the aortic valve peak-to-peak gradients decreased from 60 to 8 mmHg and 120 to 30 mmHg respectively, the LV end-diastolic pressures decreased from 47 to 13 mmHg and 40 to 15 mmHg, the LV ejection fractions improved from 40 to 65% in the second girl. On follow-up [30 and 36 ms respectively], both patients were asymptomatic with normalization of LV function and without a change in the residual gradient a cross the aortic valve