Outcome of percutaneous balloon pulmonary valvuloplasty for patients with pulmonary valve stenosis / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To assess the effects of percutaneous balloon pulmonary valvuloplasty (PBPV) for patients with pulmonary valve stenosis (PS).</p><p><b>METHODS</b>From February 1996 to March 2003, 65 patients with isolated PS were diagnosed by echocardiography and received PBPV in our department, clinical data were analyzed in this study.</p><p><b>RESULTS</b>Age of 65 patients ranged from 1 to 48 years [mean (13.5 +/- 9.3) years]. The pulmonary transvalvular gradient (PTG) was (86.4 +/- 33.6) mm Hg(1 mm Hg = 0.133 kPa) and the right ventricular systolic pressure was (107.5 +/- 36.5) mm Hg before PBPV. Single-balloon valvuloplasty was performed in 41 patients, double-balloon valvuloplasty in 6 patients and Inoue-balloon valvuloplasty in 18 patients. The ratio of balloon/valve ranged from 1.00 to 1.19 in 19 patients, from 1.20 to 1.39 in 42 patients, and greater than 1.40 in 4 patients. The procedure was classified as successful when the RV-PA gradient was < 36 mm Hg post procedure, 6 to 12 months follow up was finished after PBPV by catheterization or echocardiography in 25 patients. Immediate post procedure success rate was 81.5% (53/65). The lowest PTG immediately post procedure was seen in Inoue balloon group and balloon/valve ratio between 1.20 to 1.39 group. Post procedure, tricuspid valve regurgitation was evidenced in 2 patients, reactive right ventricular outflow tract stenosis was shown in 26 patients (13 from Inoue group) and pulmonary regurgitation was detected in 3 patients. The mean PTG was (35.7 +/- 23.9) mm Hg at follow-up. PTG gradually reduced to normal in 6 patients with post procedure PTG > or = 36 mm Hg. Right ventricular outflow tract stenosis was attenuated in all 11 followuped patients. There was no restenosis during follow-up.</p><p><b>CONCLUSION</b>Percutaneous balloon valvuloplasty was effective and safe for treating patients with pulmonary valve stenosis. Superior outcome was linked with balloon/valve ratio between 1.20 to 1.39 and Inoue balloon valvuloplasty in this cohort.</p>