Long-term results of percutaneous pulmonary valvuloplasty in adults

We performed percutaneous balloon valvuloplasty of the pulmonary valve in 24 patients (aged 17 to 72 years) and in two juvenile patients. There were no major complications. In almost all the patients the procedure resulted in a successful pressure gradient reduction from a mean of 92 +/- 36 mmHg to 43 +/- 19 mmHg (P less than 0.01). In seven patients there was a residual pressure gradient greater than 50 mmHg which, however, decreased in all patients within the following 3-12 months due to a decrease in subvalvular muscular hypertrophy (from a mean of 70 to 35 mmHg). No restenosis was observed. Only one patient, who had calcified valve leaflets, developed pulmonary insufficiency and this was of only minor haemodynamic importance. Balloon dilatation of the pulmonary valve can be considered a technique with a high success rate and low complication rate even in the elderly. Good long-term results support this approach as the first choice in the treatment of pulmonary valve stenosis.