In:
Cardiology in the Young, Cambridge University Press (CUP), Vol. 27, No. 8 ( 2017-10), p. 1566-1570
Abstract:
Pulmonary balloon valvuloplasty is a safe and effective treatment for children with pulmonary valve stenosis. A few studies evaluate the long-term outcomes of the procedure, particularly the degree of pulmonary regurgitation. We evaluated the outcomes of children 〉 1 year following valvuloplasty for pulmonary valve stenosis. Methods A retrospective analysis of children with pulmonary valve stenosis following pulmonary balloon valvuloplasty at a single institution was performed. Clinic summaries, catheterisation data, and echocardiographic data were reviewed. Inclusion criteria were isolated pulmonary valve stenosis, age 〈 19 years at the time of intervention, and at least one echocardiogram performed at least 1 year after valvuloplasty. Results A total of 53 patients met inclusion criteria. The median age at valvuloplasty was 0.4 years (0.01–10.6 years). The last follow-up was 4.8±2.3 years following valvuloplasty. The pre-valvuloplasty peak instantaneous gradient by echocardiography was 60.6±14.6 mmHg. The peak gradient at the first postoperative echocardiography was reduced to 25.5±12 mmHg (p 〈 0.001), and further decreased to 14.8±15.8 mmHg (p 〈 0.001) at the most recent follow-up. The degree of regurgitation increased from before valvuloplasty to after valvuloplasty (p 〈 0.001) but did not progress at the most recent follow-up (p=0.17). Only three patients (5.7%) required re-intervention for increasing pulmonary stenosis (two surgical; one repeat balloon). No significant procedural complications occurred. Conclusions Pulmonary balloon valvuloplasty remains a safe and effective treatment for children with isolated pulmonary valve stenosis, with excellent long-term outcomes and no mortality. A few patients require further intervention. Long-term follow-up demonstrates decreased, residual stenosis. Patients have a small, acute increase in pulmonary regurgitation following valvuloplasty, but no long-term progression.
Type of Medium:
Online Resource
ISSN:
1047-9511
,
1467-1107
DOI:
10.1017/S1047951117000804
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2017
detail.hit.zdb_id:
2060876-7
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