EFFECT OF THE BALLOON-ANULUS RATIO ON THE INTERMEDIATE AND FOLLOW-UP RESULTS OF PULMONARY BALLOON VALVULOPLASTY

Pulmonary balloon valvuloplasty (PBV) is an effective method to treat congenital valvular pulmonic stenosis, but the ideal balloon-anulus ra tio (BAR) for this procedure remains unclear. We studied 71 procedures where BARs of 1.0-1.5 were used, since it has been shown that a ratio of <1.0 is less effective and that of >1.5 may produce more complicat ions. A curvilinear relation was found between BAR and the fractional fall in haemodynamic parameters reflecting stenosis severity, both imm ediately after dilatation and at follow-up, Best results were observed with a BAR of 1.25, with progressive worsening on either side of this ratio. The relationship remained significant in multiple regression a nalysis involving age, sex and baseline haemodynamic variables. The da ta show that a BAR of 1.25 is probably the ideal ratio for PBV.