PERCUTANEOUS TRANSLUMINAL VALVULOPLASTY OF CONGENITAL PULMONARY STENOSIS IN THE ADULT - RESULTS IN 34 CASES

Percutaneous pulmonary valvulotomy is the treatment of choice for isol ated congenital pulmonary valvular stenosis in childhood. However, exp erience of this procedure in the adult is much more limited. Between J anuary 1984 and December 1994, 34 patients with severe or moderate pul monary valvular stenosis underwent percutaneous transluminal valvulopl asty. The age of the patients ranged from 20 to 47 years (mean 22 +/- 4 years). Cardiac catheterisation was performed using the femoral Vein in 27 cases and the internal jugular Vein in 7 cases. Success was obt ained in 28 patients (81% of cases). Pulmonary artery - right ventricu lar pressure gradient decreased from 113 +/- 35 to 32 +/- 13 mmHg (p < 0.001) after valvuloplasty with one or two balloon catheters. The tol erance of transluminal valvuloplasty was generally good. The poor resu lts were explained by cases of dysplasic valves or of infundibular rea ctions. There was one death which occurred 24 hours after the procedur e. Clinical and echocardiographic follow-up was obtained in 20 patient s, 3 to 36 months after valvuloplasty (average : 23 +/- 13 months). No cases of restenosis were observed. Percutaneous transluminal pulmonar y valvuloplasty in the adult is feasible and gives good results which are maintained at medium-term; it has became the treatment of choice o f valvular pulmonary stenosis and gives good results which are maintai ned at medium-term, thereby avoiding surgical valvulotomy.