MEDIUM-TERM TO LONG-TERM RESULTS AFTER PE RCUTANEOUS BALLOON PULMONARY VALVULOPLASTY IN CHILDHOOD

Pulmonary balloon valvu loplasty was performed in 52 patients aged 7 d ays to 19 years (mean 5.5 years). Mean balloon/anulus ratio was 1.24. Mean right ventricular outflow tract (RVOT) systolic pressure gradient was 79.9 +/- 37.3 (x +/- SD) mm Hg be fore valvuloplasty and 37.2 +/- 29.6 mm Hg (p < 0.001) immediately after the procedure. 33 patients h ad residual RVOT-gradient less than or equal to 36 (22 +/- 7) mm Hg, 1 9 patients had gradients > 36 (67.1 +/- 35.6) mm Hg. During intermedia te follow-up (< 2 year;) RVOT gradient assessed by catheterization or Doppler echocardiography improved without any additional intervention in 10/19 patients with RVOT gradient > 36 mm Hg early after valvulopla sty. 6/19 patients required additional reduction of RVOT gradient by r epeated valvuloplasty (51 +/- 19 to 29 +/- 5 mmHg; p < 0.01). 3/19 pat ients needed surgical resection of extremely thickened dysplastic valv es. 49 patients had a mid- to long-term follow-up by echocardiography (mean 4.3, max. 9 years); the RVOT gradient decreased from 25.7 +/- 12 .8 mmHg during intermediate follow-up to 18.0 +/- 7.0 mm Hg during lon g-term follow-up. Lf pulmonary regurgitation was pre sent after dilata tion (n = 38), it was hemodynamically not significant and did not chan ge during follow-up. Percutaneous balloon valvuloplasty was a safe and effective treatment for pulmonary valve stenosis in infancy and child hood. Long-term results confirm the value of this method.