Background and aim of the study: The study aim was to define the long-term
outcome of pulmonary balloon valvulotomy (PBV) in adult patients.
Methods: PBV was performed in 87 patients (46 females, 41 males; mean age 2
3 +/- 9 years; range: 15-54 years) with congenital pulmonary valve stenosis
WS). Intermediate follow up catheterization (mean 14.6 +/- 5.0; range: 6-2
4 months) was performed after PBV in 53 patients. Clinical and Doppler echo
cardiography examinations were carried out annually in 82 patients (mean 8.
0 +/- 3.9; range: 2-15 years).
Results: There were no immediate or late deaths. The mean catheter peak pul
monary gradient (PG) before and immediately after PBV, and at intermediate
follow up was 105 +/- 39, 34 +/- 26 (p < 0.0001) and 17 +/- 14 (p < 0.0001)
mmHg, respectively. The corresponding values for right ventricular (RV) pr
essure were 125 +/- 38, 59 +/- 21 (p < 0.0001) and 42 +/- 12 (p < 0.0001) m
mHg, respectively. The infundibular gradients immediately after PBV and at
intermediate follow up were 31 +/- 23 and 14 +/- 9 mmHg (p < 0.0001), whils
t cardiac index improved from 2.68 +/- 0.73 to 3.1 +/- 0.4 l/min/m(2) (p <
0.05) at intermediate follow up. Doppler PG before PBV and at intermediate
and long-term follow up were 91 +/- 33 (range 36-200) mmHg, 28 +/- 12 (rang
e 10-60) mmHg (p < 0.0001) and 26 +/- 11 mmHg (p = 0.2), respectively. New
pulmonary regurgitation (PR) was noted in 21 patients (25%) after PBV. Five
patients (6%) with a suboptimal result (immediate valve gradient greater t
han or equal to 30 mmHg) developed restenosis and underwent repeat valvulot
omy 6-12 months later using a larger balloon, and with satisfactory outcome
. Moderate to severe tricuspid regurgitation (TR) in seven patients regress
ed after PBV.
Conclusion: The long-term results of PBV in adults are excellent, with regr
ession of concomitant, severe infundibular stenosis and/or severe TR. Hence
, PBV should be considered as the treatment of choice for adult patients wi
th PS.