Percutaneous transluminal balloon dilatation in supravalvular aortic stenosis

Successful Percutaneous Balloon Dilatation of Supravalvular Aortic Membrane

Supravalvular aortic stenosis is the least common type of left ventricular outflow tract obstruction. Primary balloon dilatation of membranous supravalvular aortic stenosis was performed in a 10-year-old male child with a remarkable reduction in systolic pressure gradient. Balloon dilatation is a feasible treatment modality for membranous supravalvular aortic stenosis. It provides good immediate results and sustained relief of stenosis.

High-pressure balloon dilation in a dog with supravalvular aortic stenosis

A 6-month-old female intact Goldendoodle was presented for diagnostic work up of a grade IV/VI left basilar systolic heart murmur. An echocardiogram was performed and revealed a ridge of tissue distal to the aortic valve leaflets at the sinotubular junction causing an instantaneous pressure gradient of 62 mmHg across the supravalvular aortic stenosis and moderate concentric hypertrophy of the left ventricle. Intervention with a high-pressure balloon dilation catheter was pursued and significantly decreased the pressure gradient to 34 mmHg. No complications were encountered. The patient returned in 5 months for re-evaluation and static long-term reduction in the pressure gradient was noted.

Balloon dilatation of supravalvular aortic stenosis: a report of two cases

Balloon dilatation was performed in two cases of supravalvular aortic stenosis with variable results. There was remarkable reduction in gradient in the patient with membranous obstruction and the benefits are sustained at 18 months follow-up. The patient with hour-glass obstruction had only a partial success with reappearance of obstruction within 1 week. Balloon dilatation may emerge as a viable treatment modality for membranous obstructions. However, a large study is needed to establish the place of this procedure.

Initial experience with balloon dilatation of supravalvar aortic stenosis

Primary balloon dilatation of supravalvar aortic stenosis was attempted in three patients: a 20 year old woman, a seven month old boy, and a 12 year old girl. Balloon catheters (Mansfield) with diameters of 25 mm, 8 mm, and 15 mm were used in the three patients respectively. The systolic pressure gradient across the aortic narrowing decreased considerably and the diameter of the constricted area increased significantly. Balloon dilatation was feasible and provided good immediate results and sustained relief of supravalvar aortic stenosis in these three patients. However, a larger study is needed to establish the place of this procedure in treatment.