Long-term Results of Balloon Pulmonary Valvuloplasty in Children with Congenital Pulmonary Valve Stenosis

Mostafa Behjati-Ardakani; Seyed-Hossien Moshtaghion; Shahrokh Rajaei

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Long-term Results of Balloon Pulmonary Valvuloplasty in Children with Congenital Pulmonary Valve Stenosis

Author(s):

Mostafa Behjati-Ardakani^1,*,

Seyed-Hossien Moshtaghion²,

Shahrokh Rajaei³

IJ Pediatrics:Vol. 23, issue 1; 32-36

Published online:Dec 25, 2012

Article type:Research Article

Received:Jun 21, 2012

Accepted:Sep 29, 2012

How to Cite:Mostafa Behjati-ArdakaniSeyed-Hossien MoshtaghionShahrokh RajaeiLong-term Results of Balloon Pulmonary Valvuloplasty in Children with Congenital Pulmonary Valve Stenosis.Iran J Pediatr.23(1):32-36.

Abstract

Objective: 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.
Methods: 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.
Findings: 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.
Conclusion: 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.

Keywords

Pulmonary Valve Stenosis

Balloon Valvuloplasty

Children

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