RESUMO
Immediate, short and midterm outcome of balloon pulmonary valvuloplasty are well known, but there is limited information on long term results. We report long term results of 2-13. 5 years follow up of balloon pulmonary valvuloplasty in children. From June 1998 to January 2012 sixty consecutive patients [33 females, 27 males] with moderate to severe valvar pulmonary stenosis [right ventricular to pulmonary artery pressure gradient greater than 50 mmHg] were considered for balloon valvuloplasty. The gradient was measured pre and immediately post-valvuloplasty at catheterization, and then by echocardiography at follow up. Follow up studies were performed 2-13.5 years [mean +/- SD; 7.1 +/- 2.5 years, median: 5.5 years] after procedure, by Doppler echocardiography in all patients and catheterization and angiography in two patients. Balloon pulmonary valvuloplasty BPV was successful in 53 of 60 [88.3%] patients whereas surgical valvotomy was necessary in 6 to 60 [10%]. There was one immediate death due to perforation of the right ventricular outflow tract. Pulmonary valve systolic pressure gradient decreased from 83.3 +/- 32.1 to 19.3 +/- 14.2 mmHg immediately after BPV and to 12.3 +/- 6.6 mmHg at late follow up [P<0.001]. Pulmonary insufficiency was noted in 20 [38%] patient at short-term, but it was demonstrated in 17 [32%] at late follow up. A second valvuloplasty was performed in two [3.8%] patients presenting with re-stenosis. The short, intermediate and long-term outcomes of pulmonary balloon valvuloplasty in children are excellent. Therefore it can be considered as the treatment of choice for children with pulmonary valve stenosis