Severe calcific pulmonic valve stenosis and restrictive ventricular septal defect in a 64-year-old man. Results of percutaneous double balloon valvuloplasty.

The clinical and hemodynamic features of a 64-year-old symptomatic man with severe calcific pulmonic valve stenosis and restrictive ventricular septal defect are reported. Successful double balloon percutaneous pulmonic valvuloplasty immediately produced excellent symptomatic benefit and introduced expected and well tolerated hemodynamic changes. The transpulmonic valve peak systolic pressure gradient was reduced from 130 to 30 mmHg and pulmonary artery pressure increased to top normal levels acquiring normal pulse wave configuration. A left-to-right shunt, negligible prior to valvuloplasty, increased appreciably producing a pulmonary to systemic flow ratio of 1.7. Reevaluation at 5 months revealed sustained hemodynamic profile. Symptomatic benefit and tolerance to ordinary physical activities have remained excellent at 1 year follow-up.