Balloon dilation of XXXX . Results and influence of technical and morphological features on outcome.

@entity1 @entity850 @entity66 @entity337 @entity472
We evaluated dilation technique (n = 80) and aortic valve morphology by two-dimensional echocardiography (n = 58) in @entity1 with @entity472 to determine their influence on outcome. @entity1 ' age (9 +/- 9 years; range, 1 day-39 years) and a history of surgical valvotomy did not influence outcome. The number of dilating balloons (one vs. two) and balloon: annulus ratio based on the largest balloon used in each case (97 +/- 12%; range, 71-133%) did not demonstrably influence the percent reduction in valvar gradient. In contrast, with a balloon: annulus ratio greater than 100%, the incidence (26%) of significant, dilation-induced @entity337 was higher than occurred when the ratio was equal to or less than 100% (11%). Fifty bicommissural and eight unicommissural valves were identified echocardiographically. Relief of obstruction was associated with apparent commissural division in 24 of 32 @entity1 with suitable postdilation studies. The sites of fusion and @entity850 relief did not influence percent reduction in valvar gradient. Substantial increases in @entity337 (greater than three of five grades) occurred in three of eight unicommissural and one of 50 bicommissural valves. The presence of a thick valve was associated with a slightly lower gradient reduction (53 +/- 12%) than thin and pliant valves (63 +/- 24%) (p greater than 0.05). Unlike all other @entity66 we have studied, dilation technique and balloon size appeared to have a lesser influence on percent reduction in valvar gradient in @entity472 , although balloon: annulus ratio influences the increase in @entity337 . Valve morphology appears to assist with predicting the outcome of dilation.
