Immediate, Short, Intermediate and Long-Term Results of Balloon Valvuloplasty in Congenital Pulmonary Valve Stenosis

  • Mostafa Behjati-Ardakani Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Seyed Khalil Forouzannia Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Mohammad Hassan Abdollahi Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • Mohammadtaghi Sarebanhassanabadi Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Keywords:
Congenital Pulmonary Valve Stenosis, Balloon Valvuloplasty, Follow up

Abstract

Transluminal balloon valvuloplasty is an alternative to surgical valvotomy for congenital pulmonary valve stenosis. The aim of this study was to evaluate the long term results (to 13.5 years) of balloon pulmonary valvuloplasty. From June 1998 to January 2012, percutaneous balloon pulmonary valvuloplasty for congenital pulmonary valve stenosis was performed in 98 patients (50 males, 48 females, with a median age of 6.75 years) underwent balloon valvuloplasty of pulmonary valve stenosis. Follow-up was performed based on the Doppler echocardiographic data and clinical findings. Forty three of ninety eight patients were 10 years of age or older. The mean peak to peak pressure gradient across pulmonary valve before and immediately after balloon pulmonary valvuloplasty (BPV) was 88.7±36.4 mmHg and 21.8±15.9 mmHg (P<0.001) respectively. Doppler pressure gradient across pulmonary valve before BPV, at 3 month (short term), at 1 year (intermediate term) and long-term follow-up were 93.2±41.3 mmHg, 18.7±15.8 mmHg (P<0.001), 15.8±13.1 mmHg (P<0.001) and 13.6±7.4 mmHg (P<0.017) respectively. Mild pulmonary regurgitation (PR) was observed in 55 (57%) patients immediately after BPV and 30 (31%) patients at late follow up. Rupture of the right ventricular outflow tract was the major complication in two patients with fatal event. Short, intermediate and long-term results of BPV for typical valvular pulmonary stenosis are excellent. Therefore, it can be considered as treatment of choice for patients with typical valvular pulmonary stenosis.

References

Kan JS, White RI Jr, Mitchell SE, Gardner TJ. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary valve stenosis. N Engl JMed 1982;307(9):540-2.

Schmaltz AA, Bein G, Grävinghoff L, Hagel K, Hentrich F, Hofstetter R, Lindinger A, Kallfelz HC, Krame HH, Mennicken U, Mocellin R, Pfefferkorn J.R, Redel D, Rupprath G, Singer W, Sebening W, Ulmer H, Vogt J, Wessel A. Balloon valvuloplasty of pulmonary stenosis in infants and children: co-operative study of the GermanSociety of Pediatric Cardiology. Eur Heart J 1989;10(11):967-71.

Santoro G, Formigari R, Di Carlo D, Pasquini L, Ballerini L. Midterm outcome after pulmonary balloon valvuloplasty in patients younger than 1 year of age. Am J Cardiol 1988;75(8):637-9.

Stanger P, Cassidy SC, Girod DA, Kan JS, Lababidi Z, Shapiro SR. Balloon pulmonary valvuloplasty: results of the valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990;65(11):775-83.

Akçurin G, Kahramanyol O, Atakan C. Intermediate-termfollow-up results of pulmonary balloon valvuloplasty inchildren. Turk J Pediatr 2000;42(2):126-31.

Luo F, Xu WZ, Xia CS, Shi LP, Wu Xj, Ma XL, Chen Z. Percutaneous balloon pulmonary valvuloplasty for critical pulmonary stenosis in infants under 6 months of age and short and medium term follow-up. Zhonghua Er Ke Za Zhi 2011;49(1):17-20.

Cheragh H, ul Hassan M, Hafizullah M, Gul AM. Outcome of balloon pulmonic valvuloplasty with 18months follow up. J Ayub Med Coll Abbottabad 2009;21(3):95-9.

Hernáez Cobeño MA, Bermúdez-Cañete R, Herraiz I, Fernández Pineda L, Quero Jiménez C, Díaz García P. Percutaneous balloon pulmonary valvuloplasty: the medium-term results in a series of 100 consecutive pediatric patients. An Esp Pediatr 1998;49(3):264-72.

Hatem DM, Castro I, Haertel JC, Rossi RI, Zielinsky P, Leboute FC, Pomar N, Winckler M, Kersten RN, Cardoso CR, Gottschall CA. Short- and long- term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis. Arq Bras Cardiol 2004;82(3):221-7.

Juárez Rodríguez M, Alva Espinosa C, Ledesma Velasco M, Lázala Rodríguez GG, Jiménez Arteaga SS, Sánchez Soberanes AA, Ortegón Cardeña JJ, David Gómez FF, Hernández González MM, Magaña Serrano JJ. Balloon pulmonary valvuloplasty, 15-year experience at the SigloXXI IMSS National Medical Center. Arch Cardiol Mex 2003;73(3):190-6.

Lázaro Castillo JL, Munayer Calderón J, Aldana Pérez T, San Luis Miranda R, Maza Juárez G, Ramírez Reyes H, Roberto Quintero L, Arias Monroy L, Campos Gómez A.Pulmonary valvuloplasty. Long term results at the Centro Medico la Raza. Arch Inst Cardiol Mex 1999;69(4):338-43.

Jarrar M, Betbout F, Farhat MB, Maatouk F, Gamra H, Addad F, Hammami S, Hamda KB. Long-term invasiveand noninvasive results of percutaneous balloon pulmonary valvuloplasty in children, adolescents, and adults. Am Heart J 1999;138(5 Pt1 1):950-4.

Mahnert B, Paul T, Luhmer I, Kallfelz HC. Intermediate and long-term outcome after percutaneous balloondilatation of valvular pulmonary stenoses in childhood. Z Kardiol 1996;85(7):482-8.

Yu ZX, Ma YT, Yang YN, Huang D, Ma X, Fu ZY, Liu F. Outcome of percutaneous balloon pulmonary valvuloplasty for patients with pulmonary valve stenosis. Zhonghua Xin Xue Guan Bing Za Zhi 2009;37(11):1006-9.

Weryński P, Rudziński A, Król-Jawień W, Kuźma J. Percutaneous balloon valvuloplasty for the treatment ofpulmonary valve stenosis in children - a single centre experience. Kardiol Pol 2009;67(4):369-75.

O’Connor BK, Beekman RH, Lindauer A, Rocchini A. Intermediate-term outcome after pulmonary balloon valvuloplasty: comparison with a matched surgical control group. J Am Coll Cardiol 1992;20(1):169-73.

Rao PS, Fawzy ME, Solymar L, Mardini MK. Long-term results of balloon pulmonary valvuloplasty of valvar,pulmonic stenosis. Am Heart J 1988;115(6):1291-1296.

McCrindle BW, Kan JS. Long-term results after balloon pulmonary valvuloplasty. Circulation 1991;83(6):1915-22.

Nugent EW, Freedom RM, Nora JJ, Ellison RC, Rowe RD, Nadas AS. Clinical course in pulmonary stenosis. Circulation 1977; 56(1 Suppl):I38-47.

Geva T, Sandweiss BM, Gauvreau K, Lock JE, Powell AJ. Factors associated with impaired clinical status in longterm survivors of tetralogy of Fallot repair evaluated by magnetic resonance imaging. J Am Coll Cardiol 2004;43(6):1068-74..

Gildein HP, Kleinert S, Goh TH, Wilkinson JL. Treatment of critical pulmonary valve stenosis by balloon dilatationin the neonate. Am Heart J 1996;131(5):1007-11.

Luo F, Xu WZ, Xia CS, Shi LP, Wu XJ, Ma XL, Chen Z . Percutaneous balloon pulmonary valvuloplasty for critical pulmonary stenosis in infants under 6 months of age and short and medium term follow-up. Zhonghua Er Ke Za Zhi 2011;49(1):17-20.

Liu F, Wu L, Huang GY, Zhang LF, Qi CH, Ma XJ, Liang XC. Percutaneous balloon valvuloplasty for severe and critical pulmonary valve stenosis in infants under six months. Zhonghua Yi Xue Za Zhi 2009;89(46):3253-6.

Buheitel G, Böhm B, Koch A, Trusen B, Hofner G, Singer H. Balloon dilatation of the pulmonary valve. Short-, middle- and long. Z Kardiol 2001;90(7):503-9.

Fawzy ME, Hassan W, Fadel BM, Sergani H, El Shaer F, El Widaa H, Al Sanei A. Long-term results (up to 17 years) of pulmonary balloon valvuloplasty in adults and its effects on concomitant severe infundibular stenosis and tricuspid regurgitation. Am Heart J 2007;153(3):433-8.

How to Cite
1.
Behjati-Ardakani M, Forouzannia SK, Abdollahi MH, Sarebanhassanabadi M. Immediate, Short, Intermediate and Long-Term Results of Balloon Valvuloplasty in Congenital Pulmonary Valve Stenosis. Acta Med Iran. 51(5):324-328.
Section
Articles