Balloon dilatation in infants and children with dysplastic pulmonary valves: short-term and intermediate-term results.

This study was designed to document the results of balloon valvuloplasty in patients with dysplastic pulmonary valves and to determine whether dysplastic pulmonary valves are responsible for recurrence of stenosis after balloon pulmonary valvuloplasty. Balloon valvuloplasty in 13 patients, aged 6 days to 12 years (median 1 year), with dysplastic pulmonary valves reduced the pulmonary valve gradient from 77.2 +/- 44.2 (mean +/- SD) to 26.8 +/- 17.0 mm Hg (p less than 0.001), which remained improved (34.9 +/- 34.6 mm Hg; p less than 0.02) at 6 to 19 months' (mean 10 months) follow-up. Valvuloplasty in 43 patients without dysplastic pulmonary valves reduced the valvar gradient from 94.3 +/- 41.0 to 31.1 +/- 22.4 mm Hg (p less than 0.001) immediately after the procedure, which at 6 to 34 months' follow-up in 23 patients was 29.2 +/- 33.5 mm Hg (p less than 0.001). The right ventricular peak systolic pressures (96.2 +/- 43.3 vs 112.1 +/- 40.1 mm Hg) and pulmonary valvar gradients (77.2 +/- 44.2 vs 94.3 +/- 41.0 mm Hg) before valvuloplasty, residual right ventricular pressures (52.9 +/- 14.5 vs 56.1 +/- 24.2 mm Hg) and pulmonary valvar gradients (26.8 +/- 17.0 vs 31.1 +/- 22.4 mm Hg) immediately after valvuloplasty, and residual right ventricular pressures (59.3 +/- 30.3 vs 53.6 +/- 34.3 mm Hg) and pulmonary valvar gradients (34.9 +/- 34.6 vs 29.2 +/- 33.5 mm Hg) at follow-up catheterization were similar (p greater than 0.1) in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)