IMMEDIATE THERAPEUTIC OUTCOMES OF TRANS CATHETER PULMONARY BALLOON VALVULOPLASTY FOR CRITICAL PULMONARY STENOSIS

Abstract

Objective: To share a single centre experience of percutaneous balloon valvuloplasty for critical pulmonary valve stenosis.

Study Design: A retrospective cross sectional study.

Place and Duration of study: This study was conducted at AFIC/NIHD Rawalpindi, from Aug 2010 to Dec 2015.

Materials and Methods: In this study a retrospective analysis of all consecutive infants who underwent BVP for critical PVS was carried out to assess its immediate efficacy and safety.
Results: A total of 28 infants diagnosed with critical PVS were enrolled. Male to female ratio was 1.5:1. Pulmonary valve (PV) annulus mean diameter was 12 ± 4.2. Mean age of pulmonary BVP was 6 ± 8 years and average balloon to PV annulus ratio was 1.35. Immediate success was achieved in 100% by significant reduction of transpulmonary valve peak pressure gradient (p<0.001). One death occurred 5 days after the procedure, 21.4 % had
complications and none of our patient needed re-intervention in the immediate post procedure period or before discharge.

Conclusion: Percutaneous BVP was found very effective and safe intervention for critical narrowing of pulmonary valve in order to gain time for further intervention needed in a high risk age group for surgery. Balloon pulmonary valvuloplasty is equally successful in neonates as well as in adult subjects and is the treatment of choice for relief of pulmonary valve stenosis. Surgery should be reserved for unsuccessful BVP. Life-long followup to identify the significance of residual pulmonary insufficiency is indicated.