Percutaneous balloon pulmonary valvuloplasty--the Singapore General Hospital experience

Percutaneous balloon pulmonary valvuloplasty was performed in ten children aged 4 months to 9 years (mean age = 3.9 years). Their weights ranged from 5.6 to 38 kg (mean = 16.1 kg). Seven had typical pulmonary valve stenosis, two had pulmonary atresia and previous surgical valvotomy and one had dysplastic pulmonary valve. In patients with typical pulmonary valve stenosis, significant reductions in the right ventricular systolic pressure and pulmonary systolic pressure gradients were observed immediately after balloon dilatation. Follow-up evaluation by Doppler echocardiography at six months to two years showed further reduction in pulmonary gradients in five, and in the other two, the gradients remained low. Reduction in right ventricular pressure was less in patients with pulmonary atresia and previous surgical valvotomy and patients with dysplastic pulmonary valve. Balloon pulmonary valvuloplasty is a safe and effective procedure for the relief of typical pulmonary valve stenosis. In patients with pulmonary atresia and previous surgical valvotomy, balloon valvuloplasty can be an effective palliation for decompressing the right ventricle and improving pulmonary blood flow.