Surgical interventions after endovascular correction of aortic valvular stenosis in neonates

Introduction. There is the necessity to choose either X-ray endovascular balloon dilation or surgical valvuloplasty during treatment of congenital aortic valve stenosis in neonates. Objective. To determine freedom from surgical interventions after endovascular correction of aortic valvular stenosis in neonates. Methods. Endovascular balloon dilation was performed in 96 neonates with aortic valve stenosis at the RSPC "Cardiology" and RSPC of pediatric surgery from 2005 to 2025. The mean age was 3.0 (1.0–8.0) days and the mean body weight was 3.5 (3.2–3.8) kg at the time of endovascular intervention. Isolated congenital aortic valve stenosis was diagnosed in 76 (79.2%) patients, and concomitant congenital heart defects were present in 20 (20.8%) patients. We performed balloon dilation using femoral artery puncture, while in 1 (1.0%) premature newborn with body weight 1.7 kg the right common carotid artery was used. Results. There was 1 death (1.0%) during hospital stay after balloon valvuloplasty, and intraoperative complication was observed in 1 patient (1.0%). Repeated endovascular balloon dilation was performed due to high residual systolic pressure gradient on the aortic valve in 25 (26.0%) children. After balloon dilation, 36 (37.5%) children underwent surgical interventions due to severe aortic valve insufficiency. Of those, Ross procedure was performed in 11 children, reconstructive operation in 10, neocuspidization in 9, and replacement with mechanical prosthesis in 6. Conclusion. Freedom from surgical interventions was 79.9% at 5 years and 63.8% at 10 years after endovascular correction of aortic valvular stenosis in newborns.