Left ventricular diastolic heart failure in teenagers who underwent balloon aortic valvuloplasty in early infancy

The American Journal of Cardiology
Joshua D RobinsonAndrew J Powell

Abstract

We report 4 teenage patients who, after successful palliation of severe aortic valve stenosis by balloon aortic valvuloplasty in early infancy, presented within the previous 3 years with significant left ventricular (LV) diastolic heart failure. All patients had remained asymptomatic until their teenage years and had normal or hyperdynamic LV systolic function on presentation, with limited residual aortic valve stenosis and regurgitation. All underwent echocardiography, cardiac catheterization, and cardiac magnetic resonance evaluation. One notable common feature in the 4 patients was the presence of a confluent layer of LV subendocardial hyperenhancement demonstrated by late gadolinium enhancement technique. Histopathology was available for 2 patients, which documented significant LV endocardial fibroelastosis. One patient who underwent endocardial fibroelastosis resection in conjunction with aortic valve replacement had late clinical improvement. In conclusion, this group of patients may represent an important emerging clinical entity and merits close clinical surveillance, with prospective assessment of diastolic function.

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Citations

Jun 15, 2013·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Sohrab FratzAndrew J Powell
Aug 1, 2015·Prenatal Diagnosis·Lindsey E HunterJohn M Simpson
Oct 30, 2012·The American Journal of Cardiology·Kevin G FriedmanDavid W Brown
Jan 1, 2016·Pediatric Radiology·Maryam EtesamiPrabhakar Rajiah
Feb 25, 2014·Pediatric Cardiology·Allison C HillRahul H Rathod
Jun 1, 2011·The American Journal of Cardiology·Kevin G FriedmanWayne Tworetzky
Sep 8, 2015·The American Journal of Cardiology·Susan M DusenberyAndrew J Powell
May 14, 2014·The American Journal of Cardiology·Kevin G FriedmanWayne Tworetzky
Nov 8, 2014·American Journal of Respiratory and Critical Care Medicine·M J Del Cerro MarínUNKNOWN REHIPED Investigators
May 14, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Rahul H RathodTal Geva
Jul 18, 2018·Echo Research and Practice·Lindsey E Hunter, Anna N Seale
Oct 12, 2018·Echo Research and Practice·Lindsey E Hunter, Anna N Seale
Jun 8, 2021·Circulation. Cardiovascular Interventions·Takashi KidoMeena Nathan

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