Pulmonary balloon valvuloplasty in high risk patients

ABSTRACT

Transcutaneous pulmonary balloon valvuloplasty is the treatment of choice to relieve moderate to severe pulmonary valvular stenosis,the aim of our study is to propose a clinical classification for a group of patients with severe pulmonary valvular stenosis who present with particular signs and symptoms and who carry particular risks and difficulties during cardiac catheterization and pulmonary valvular angioplasty. From Aug 1993 to Sept. 2001,Pulmonary balloon valvuloplasty [PBV] was attempted in 248 patients with pulmonary valvular stenosis [moderate to severe] from early neonatal days and beyond. Among those we selected 47 patients with severe pulmonary valvular stenosis.They were devided into four groups according to their particular clinical manifestations Group AThose with pure cyanosis. Group BThose with Rt sided heart failure without cyanosis Group CThose with Rt sided failure and cyanosis. Group DThose with biventricular failure. We recognized specific risks,complications and technical difficulties in those different groups [will be mentioned in details]. Pulmonary balloon angioplasty is still the standard solution to relieve moderate to severe pulmonary valvular stenosis in all ages, but still there is a group of patients who carries technical difficulties,risks and even death with this procedure