title: [Percutaneous balloon pulmonary valvuloplasty for critical pulmonary stenosis in infants under 6 months of age and short and medium term follow-up].
abstract: OBJECTIVE
  To evaluate the effect and results of short and medium periods of follow-up of percutaneous balloon pulmonary valvuloplasty for critical pulmonary stenosis of neonates and infants under 6 months of age.
  
  
  METHODS
  Between January 2002 and December 2008, 34 consecutive patients aged from 13 to 175 days with critical pulmonary valvular stenosis underwent percutaneous balloon valvuloplasty. Patients records, catheterization data, angiograms and echocardiograms were reviewed. Patients were followed up for 6 months to 4 years (mean 25.5 months) by means of clinical examination and Doppler echocardiography.
  
  
  RESULTS
  The pulmonary valvuloplasty was accomplished in 32 (94%) of 34 attempts. Immediately after dilation, right ventricular systolic pressure (RVSP) decreased from (96 ± 28) mm Hg (1 mm Hg = 0.133 kPa) (49 ± 20) mm Hg (P < 0.01), the transvalvular peak to peak systolic gradient (ΔP) decreased from (89 ± 25) mm Hg to (25 ± 12) mm Hg (P < 0.01), and the right ventricular/aortic systolic pressure ratio decreased from 1.2 ± 0.5 to 0.7 ± 0.3 (P < 0.01). One patient died because of cardiac tamponade following rupture of the pulmonary valve annulus, 2 patients developed pericardial effusion, 3 patients had infundibular spasm, 3 patients had a pre-dilation by small balloon and 1 patient had weakened femoral artery pollex. After a follow up period of 6 months to 4 years 3 of 31 patients lost to follow-up. Repeat valvuloplasty was performed in 5 patients (3 neonates), no patient required surgery, and the other 23 patients did not undergo further intervention, a mean peak systolic Doppler gradient of (20 ± 13) mm Hg was found and no significant pulmonary regurgitation was seen.
  
  
  CONCLUSIONS
  Percutaneous balloon pulmonary valvuloplasty was effective and safe for the treatment of critical pulmonary stenosis of neonates and infants under 6 months of age with good short and medium term results.
authors.affiliation: Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Luo
authors.forename: Wei-Ze
authors.initials: WZ
authors.lastname: Xu
authors.forename: Cheng-Sen
authors.initials: CS
authors.lastname: Xia
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Shi
authors.forename: Xiu-Jing
authors.initials: XJ
authors.lastname: Wu
authors.forename: Xiao-Lu
authors.initials: XL
authors.lastname: Ma
authors.forename: Zheng
authors.initials: Z
authors.lastname: Chen
mesh_terms: D002404:Catheterization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D059012:Lost to Follow-Up; D008297:Male; D011664:Pulmonary Valve; D011666:Pulmonary Valve Stenosis / Q000628:therapy*; D016896:Treatment Outcome