[Percutaneous balloon valvuloplasty of pulmonary stenosis in childhood: early hemodynamic results and long-term Doppler echocardiography results].

Pulmonary balloon valvuloplasty was performed in 35 children aged 3 days to 18 years (mean 4.5 years). Balloon/annulus ratio was 1.21 +/- 0.12. There were 6 infants less than 1 year of age (including 1 newborn), 4 with dysplastic valves and 4 with postoperative restenosis. Systolic transvalvular gradient showed a decrease of 69 +/- 14% from 68 +/- 15 mm Hg before to 21 +/- 11 mm Hg after dilatation (p less than 0.0001), and right ventricular pressure/systemic pressure ratio decreased from 0.8 +/- 0.29 to 0.4 +/- 0.15 (p less than 0.0001). Follow-up studies were performed in all patients up to 5 years (2.5 +/- 1.3 years) after dilatation. In 63% (22/35) follow-up period was more than 2 years (3.5 +/- 0.95 years). Doppler derived gradient had further decreased to 16 +/- 11 mm Hg (n.s.). Results in the 6 infants showed an immediate gradient relief of 71 +/- 11% from 85 +/- 4 mm Hg to 25 +/- 10 mm Hg (p less than 0.0001) with a further decrease to 20 +/- 10 mm Hg at follow-up. There were two early complications which had to be treated (tachycardia in WPW-syndrome, femoral vein dissection), no late complications were seen. The good immediate results and high persistent long-term success rate confirm balloon pulmonary valvuloplasty being the treatment of first choice for all patients in childhood.