[Outcome of percutaneous balloon pulmonary valvuloplasty for patients with pulmonary valve stenosis].

OBJECTIVE

To assess the effects of percutaneous balloon pulmonary valvuloplasty (PBPV) for patients with pulmonary valve stenosis (PS).

METHODS

From February 1996 to March 2003, 65 patients with isolated PS were diagnosed by echocardiography and received PBPV in our department, clinical data were analyzed in this study.

RESULTS

Age of 65 patients ranged from 1 to 48 years [mean (13.5 +/- 9.3) years]. The pulmonary transvalvular gradient (PTG) was (86.4 +/- 33.6) mm Hg(1 mm Hg = 0.133 kPa) and the right ventricular systolic pressure was (107.5 +/- 36.5) mm Hg before PBPV. Single-balloon valvuloplasty was performed in 41 patients, double-balloon valvuloplasty in 6 patients and Inoue-balloon valvuloplasty in 18 patients. The ratio of balloon/valve ranged from 1.00 to 1.19 in 19 patients, from 1.20 to 1.39 in 42 patients, and greater than 1.40 in 4 patients. The procedure was classified as successful when the RV-PA gradient was < 36 mm Hg post procedure, 6 to 12 months follow up was finished after PBPV by catheterization or echocardiography in 25 patients. Immediate post procedure success rate was 81.5% (53/65). The lowest PTG immediately post procedure was seen in Inoue balloon group and balloon/valve ratio between 1.20 to 1.39 group. Post procedure, tricuspid valve regurgitation was evidenced in 2 patients, reactive right ventricular outflow tract stenosis was shown in 26 patients (13 from Inoue group) and pulmonary regurgitation was detected in 3 patients. The mean PTG was (35.7 +/- 23.9) mm Hg at follow-up. PTG gradually reduced to normal in 6 patients with post procedure PTG > or = 36 mm Hg. Right ventricular outflow tract stenosis was attenuated in all 11 followuped patients. There was no restenosis during follow-up.

CONCLUSION

Percutaneous balloon valvuloplasty was effective and safe for treating patients with pulmonary valve stenosis. Superior outcome was linked with balloon/valve ratio between 1.20 to 1.39 and Inoue balloon valvuloplasty in this cohort.