Long-term results of pulmonary balloon valvulotomy in adult patients

Citation
Me. Fawzy et al., Long-term results of pulmonary balloon valvulotomy in adult patients, J HEART V D, 10(6), 2001, pp. 812-818
Citations number
35
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF HEART VALVE DISEASE
ISSN journal
09668519 → ACNP
Volume
10
Issue
6
Year of publication
2001
Pages
812 - 818
Database
ISI
SICI code
0966-8519(200111)10:6<812:LROPBV>2.0.ZU;2-7
Abstract
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.