Balloon Dilatation For Discrete Subaortic Stenosis: Immediate Outcome And Hemodynamic One-Year Follow-Up

Six patients with discrete subaortic stenosis (DS) underwent percutaneous ballon dilatation over a 15- month period. The mean age was 16 years. Aortic and left ventricular outflow tract pressures were simultaneously recorded and left ventriculography and aortic root angiography were done. The mean gradient was 77±22 mmHg. In two patients 1+ and in another patient 2+ aortic insufficiency was present. Balloon dilatation was performed with 3x10 Trefoil in three and 3x12 Trefoil in three patients. The mean gradient immediately after dilatation was 24±13 mmHg. Aortic insfficiency grade did not change. Follow-up cardiac catheterisation was performed in four patients 12 months after balloon dilatation. The mean gradient was 26±8 mmHg. In patients with aortic insufficiency the grade did not change. Based on our results, and the progressive nature of the DS, balloon dilatation may be a preferable initial procedure in the treatment of isolated DS, in view of the morbidity and mortality associated with surgery.