Percutaneous Pulmonary Balloon Valvuloplasty Provides Good Long-Term Outcomes in Adults With Pulmonary Valve Stenosis.

BACKGROUND

Percutaneous balloon pulmonary valvuloplasty (PBPV) is well described in children, but data on the efficacy and long-term outcomes in adult patients with pulmonary valve stenosis (PVS) are limited.

OBJECTIVE

To estimate the long-term outcomes of PBPV in adult PVS patients.

METHODS

We performed a retrospective analysis of 41 consecutive adult cases (18 females, 23 males) with moderate to severe PVS who underwent PBPV at the First Affiliated Hospital of Soochow University between January 1999 and December 2005. Follow-up was available for all patients (mean follow-up of 11.3 ± 2.1 years; range, 9-15 years).

RESULTS

Before intervention, the peak systolic gradient (PSG) was 71.3 ± 27.8 mm Hg. Immediately after intervention, the PSG was reduced to 30.9 ± 10.9 mm Hg (P<.001). At short-term, mid-term, and long-term follow-up, the mean echocardiographic PSGs were 30.6 ± 11.9 mm Hg, 31.1 ± 16.8 mm Hg, and 27.9 ± 7.6 mm Hg, respectively (P<.001 compared with preintervention PSG). At the last follow-up, 37 of 41 patients (90.2%) had a PSG <36 mm Hg. Four patients (9.8%) underwent a second PBPV. Patients with immediate postintervention PSG ≥36 mm Hg were more likely to need a second PBPV. Two cases with immediate postintervention PSG ≥36 mm Hg experienced a spontaneous PSG reduction to <36 mm Hg. No serious adverse complications happened during or after the procedure.

CONCLUSIONS

PBPV as a treatment for PVS was safe, and provided good long-term outcomes. Some patients with less-optimal immediate results may experience a spontaneous PSG reduction. A small proportion of patients required a second PBPV, especially those with poor immediate results. Close follow-up is necessary.