Balloon dilatation of the pulmonary valve

Background Immediate and long-term results after balloon dilatation of pulm onary valve stenosis in our unit. Methods and patients All 111 patients (1 day-18 years) who have had balloon dilatation of a pulmonary valvar stenosi s between 12/1987 and 8/1997 were divided into 4 groups: Typical valvar pul monary stenosis (group A; n = 78), stenosis with dysplastic pulmonary valve (group B; n = 10), critical pulmonary stenosis (group C; n = 16) and pulmo nary atresia after transcatheter or operative opening of the valve (group D ; n = 7). Patients with pulmonary stenosis and complex congenital heart dis ease were excluded. Results The average systolic transvalvular gradient was reduced from 68.5 to 27.2 mmHg (60%) immediately after balloon dilatation. After a follow up of 48.8 +/- 37 months 101 patients could be reevaluated. In group A (n = 69 at FU) and C (n = 16 at FU) 81% showed a systolic trans valvular gradient < 30 mmHg after one and 83% (A) respective 94% (C) after two balloon dilatations. In group B (n = 9 at FU) 44% exhibited a systolic gradient < 30 mmHg after one and 56% after two balloon dilatations. In grou p D (n = 7 at FU) 57% showed a systolic gradient < 30 mmHg with no further improvement by a second dilatation. Over all, 80% of our patients could be treated sufficiently by transcatheter means. The rate of major complication s was 7.3% with no lasting residuals at follow up and no deaths. Conclusion Balloon dilatation of the pulmonary valve is secure and effective. Best re sults are obtained in patients with typical pulmonary valve stenosis and in newborns and infants with critical pulmonary valve stenosis.