Valvuloplasty with large trefoil balloons for the treatment of congenital pulmonary stenosis.

Percutaneous balloon valvuloplasty was performed in 16 children, 1 1/2 to 14 years old, with congenital pulmonary stenosis with teh use or trefoil balloons. These balloons, which consist of 3 identical angioplasty balloons, do not interrupt completely the blood flow during inflation. The size of the trefoil balloons used was 30 to 50% larger than the valve anulus. A obtain an effective pulmonary valvuloplasty in two patients with large valve anulus. The mean prevalvuloplasty systolic gradient fo 78.2 +/- 28.9 mmHg (range 40 to 140 mmHg) was reduced to 20.3 +/- 5.7 (range 10 to 30 mmHg) after valvuloplasty. No patient developed significant hypotension or bradycardia or other complications as a result of the procedure. The findings demonstrate that percutaneous balloon valvuloplasty with oversized trefoil balloons effectively treated congenital pulmonary stenosis without complications in the cases studied. The use of large trefoil instead of single balloons of a similar diameter is advantageous since they cause no significant compromise of the cardiac output during valvuloplasty.