[Percutaneous balloon valvuloplasty of pulmonary stenosis in childhood: early hemodynamic results and long-term Doppler echocardiography results].
Pulmonary balloon valvuloplasty was performed in 35 children aged 3 days to 18 years (mean 4.5 years). Balloon/annulus ratio was 1.21 +/- 0.12. There were 6 infants less than 1 year of age (including 1 newborn), 4 with dysplastic valves and 4 with postoperative restenosis. Systolic transvalvular gradient showed a decrease of 69 +/- 14% from 68 +/- 15 mm Hg before to 21 +/- 11 mm Hg after dilatation (p less than 0.0001), and right ventricular pressure/systemic pressure ratio decreased from 0.8 +/- 0.29 to 0.4 +/- 0.15 (p less than 0.0001). Follow-up studies were performed in all patients up to 5 years (2.5 +/- 1.3 years) after dilatation. In 63% (22/35) follow-up period was more than 2 years (3.5 +/- 0.95 years). Doppler derived gradient had further decreased to 16 +/- 11 mm Hg (n.s.). Results in the 6 infants showed an immediate gradient relief of 71 +/- 11% from 85 +/- 4 mm Hg to 25 +/- 10 mm Hg (p less than 0.0001) with a further decrease to 20 +/- 10 mm Hg at follow-up. There were two early complications which had to be treated (tachycardia in WPW-syndrome, femoral vein dissection), no late complications were seen. The good immediate results and high persistent long-term success rate confirm balloon pulmonary valvuloplasty being the treatment of first choice for all patients in childhood.
Stein
J I
JI
Department für Pädiatrische Kardiologie, Universitätskinderklinik Graz, Universität Graz/Osterreich.
Beitzke
A
A
Suppan
C
C
D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011666:Pulmonary Valve Stenosis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000628:therapy*
Perkutane Ballonvalvuloplastik der valvulären Pulmonalstenose im Kindesalter: Hämodynamische Frühergebnisse und Doppler-echokardiographische Langzeitergebnisse.