BALLOON PULMONARY VALVULOPLASTY IN ISOLATED PULMONARY VALVE STENOSIS VERSUS DYSPLASTIC PULMONARY VALVE IN CHILDREN PRESENTING LATE WITH RV DYSFUNCTION AND ARRYTHMIA

Abstract

Objective: To compare the result of balloon pulmonary valvuloplasty (BPV) between dysplastic pulmonary
valve (DPVS) and isolated PVS and determine various factors affecting the outcome.
Study Design: Descriptive cross sectional.
Place and Duration of Study: Children Hospital Lahore from 2006 to 2012.
Material and Methods: All patients presenting to single tertiary care hospital from June 2006 to May 2012
with severe PVS undergoing BPV were included in the study excluding patients with critical PS. The patients
were divided in dysplastic (Group1) and isolated doming (Group2) pulmonary valves based on
echocardiographic appearance of the valves. Immediate percentage reduction in gradient across PV and
complications in either group were analyzed along with frequency of RV dysfunction, balloon to annulus
ratio, pre dilatation and balloon stabilization.
Results: A total of 162 patients underwent BPV. Patients ranged from 3 months to 14 yrs with mean age + SD
was 3.7 + 4.0 yrs. There was a male predominance (M:F; 2.1:1). Mean weight was 13.5 + 10.0 kg. DPV was
found in 76 patients (46.9%). Thirty four patients (21%) had RV dysfunction at the time of intervention. There
was no significant difference between frequecy of RV dysfunction between both groups (p = 0.4). Nine (5.6%)
children were pre dilated with a smaller balloon prior to definitive BPV. (Group 1 vs Group 2, p = 0.4).
Balloon stabilization was achieved in 145 (89.5%) children. Balloon stabilization was significantly more

Conclusion: Dysplastic Pulmonary valve shows a suboptimal immediate
response to BPV compared to isolated pulmonary v.....