Long-term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis in the pediatric population.
OBJECTIVE
Percutaneous pulmonary valvuloplasty is the preferred interventional procedure for pulmonary valve stenosis. The aim of this study was to evaluate the effectiveness of this technique, assess the factors leading to its success, and determine the long-term results in the pediatric population.


METHODS
The study included 53 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty between December 1985 and December 2000. Right ventricular size and functional echocardiographic parameters, such as pulmonary regurgitation and residual transvalvular gradient, were assessed during long-term follow-up.


RESULTS
Peak-to-peak transvalvular gradient decreased from 74 mmHg [interquartile range, 65-100 mmHg] to 20 mmHg [interquartile range, 14-34 mmHg]. The procedure was unsuccessful in 2 patients (3.77%). The immediate success rate was 73.58%. Follow-up ranged from 10 years to 24 years (median, 15 years). During follow-up, all patients developed late pulmonary regurgitation which was assessed as grade II in 58.4% and grade III in 31.2%. There was only 1 case of long-term restenosis (2.1%). Severe right ventricular dilatation was observed in 27.1% of the patients. None of the patients developed significant right ventricular dysfunction. Pulmonary valve replacement was not required in any of the patients.


CONCLUSIONS
Percutaneous balloon valvuloplasty is an effective technique in the treatment of pulmonary valve stenosis with good long-term results.
Unidad de Cardiología y Hemodinámica Infantil, Hospital Virgen del Rocío, Seville, Spain. Electronic address: raquel_merino_ingelmo@yahoo.es.
Raquel
R
Merino-Ingelmo
Unidad de Cardiología y Hemodinámica Infantil, Hospital Virgen del Rocío, Seville, Spain.
José
J
Santos-de Soto
Unidad de Cardiología y Hemodinámica Infantil, Hospital Virgen del Rocío, Seville, Spain.
Félix
F
Coserria-Sánchez
Unidad de Cardiología y Hemodinámica Infantil, Hospital Virgen del Rocío, Seville, Spain.
Alfonso
A
Descalzo-Señoran
Unidad de Cardiología y Hemodinámica Infantil, Hospital Virgen del Rocío, Seville, Spain.
Israel
I
Valverde-Pérez
D063126:Balloon Valvuloplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011665:Pulmonary Valve Insufficiency / Q000601:surgery; D011666:Pulmonary Valve Stenosis / Q000601:surgery*; D016896:Treatment Outcome
Cardiopatías congénitas; Cateterismo cardiaco; Catheterization; Congenital heart disease; Echocardiography; Ecocardiografía; Estenosis pulmonar; Estudios de seguimiento; Follow-up studies; Insuficiencia pulmonar; Pediatrics; Pediatría; Pulmonary regurgitation; Pulmonary stenosis; Right ventricle; Valvuloplastia; Valvuloplasty; Ventrículo derecho