Mid-term outcomes of double-balloon technique for balloon aortic valvotomy: Experience from a tertiary care center in India.

We hypothesized that a double-balloon technique would be associated with a lower likelihood of aortic regurgitation (AR) following balloon aortic valvotomy (BAV). We present the short- and mid-term outcomes of the double-balloon technique for BAV. Fifty consecutive patients (median age: 6.5 years; interquartile range (IQR): 3.8-13.2) underwent BAV using double balloons. Prior AR was present in 17 (34%). Following BAV, the peak-to-peak gradient reduced from 80 (66.5-100) mm Hg to 24 (16-35) mm Hg (P < 0.0001); 10 (20%) had trivial AR, 18 (36%) had mild AR, 10 (20%) had moderate AR and none had severe AR. Four (8%) had transient arterial occlusion requiring anticoagulation. There was no procedure-related mortality or requirement for emergency open-heart surgery. The double-balloon technique offers a safe and effective alternative option for BAV in patients beyond infancy with relatively large annulus sizes. There is a low likelihood of postprocedural severe AR and the need for repeat procedures. Further long-term follow-up of this cohort is needed to ascertain long-term outcomes.