EXPERIENCE OF BALLOON PULMONARY VALVULOPLASTY IN ADULTS AT AFIC

Abstract

Objective: Pulmonary balloon valvuloplasty is considered as first line of treatment for isolated pulmonary valve stenosis in all age groups. This study aimed at determining immediate results and complications associated with transcatheter pulmonary valvuloplasty in adult (defined as age 18 years or more) patients.

Study Design: Retrospective quasi experimental study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National institute of heart diseases (AFIC/NIHD) Rawalpindi, from Jan 2017 to Jun 2019.

Methodology: This Retrospective Quasi experimental study was done at Paediatric cardiology department of Armed Forces Institute of Cardiology/National institute of heart diseases (AFIC/NIHD) Rawalpindi and comprised of 24 patients with severe pulmonary valve stenosis in whom balloon dilatation was attempted from January 2017 to June 2019. As per guidelines, the intervention was considered as successful if right ventricle to pulmonary artery invasive pressure gradient was reduced to less than 50% of initial value, suboptimal if PG reduced by 25% and failure if PG reduced by less than 25% of pre-procedural value.

Results: Total 24 adults patients (with no history of previous cardiac surgery or pulmonary valve ballooning) underwent balloon pulmonary valvuloplasty for pulmonary valve stenosis with mean age of 30.5 ± 10.1 years, including 11 males & 13 females with 100% success. Balloon to annulus ratio was 1.25:1. The pressure gradient between Right Ventricle to pulmonary artery reduced from 111 mmHg to 39 mmHg after the intervention. The mean procedural time and fluoroscopy time were 40 & 10 minutes respectively and there were no complications. In three patients, ASD device closure was also done in same procedure.

Conclusion: Percutaneous balloon valvuloplasty is an effective and safe option for the treatment of pulmonary valve stenosis in adult patients with excellent results.