[Balloon pulmonary valvuloplasty, 15-year experience at the Siglo XXI IMSS National Medical Center]
Mariano Juárez Rodríguez1, Carlos Alva Espinosa, Mariano Ledesma Velasco
1Hospital de Cardiología CMN Siglo XXI, IMSS, México DF Av. Cuauhtémoc 330 Col Doctores C.P. 06720 Deleg, Cuauhtémoc.
Objective:
To evaluate 15 years of experience with balloon pulmonary valvuloplasty in a single third level health care center.
Material And Methods:
Hundred-fifty patients underwent the procedure, 73 (48%) men and 77 (52%) women, mean age 10.5 +/- 11.3 years.
Results:
The initial systolic gradient decreased from 86 +/- 35 to 21.67 +/- 12.20 mm Hg, p < 0.001, whereas the initial right ventricular systolic pressure decreased from 106 +/- 34.8 to 53 +/- 27 mm Hg, p < 0.0001. At the end of the follow-up, 48 +/- 44 months, the systolic gradient was 13.43 +/- 8.73 mm Hg, p < 0.001. Major complications occurred in 9 (6.4%) patients. Immediate technical success was achieved in 111 (74%) patients and failure in 39 (26%). At the end of the follow-up period, successful outcomes were achieved in 104 (89.6%); in contrast, failures were present in 12 (10.4%) patients, p < 0.001. Death occurred in 2 (1.33%) patients. The predictors for failure were age < 1.5 +/- 1-33 years (p < 0.004), dysplastic valve (p < 0.001), high initial systolic gradient (p < 0.002), and high initial systolic right ventricular pressure (p < 0.0001).
Conclusion:
Balloon pulmonary valvuloplasty is an effective, safe, and first choice treatment for congenital pulmonary valve stenosis.
