[Problems posed by percutaneous pulmonary valvuloplasty in children]

Area of Science:

• Cardiology
• Pediatric Cardiology
• Interventional Cardiology

Context:

• Pulmonary valve stenosis (PVS) is a congenital heart defect affecting the pulmonary valve.
• Percutaneous balloon valvuloplasty is a minimally invasive treatment option for PVS.
• Efficacy and safety in pediatric populations require further investigation.

Purpose:

• To evaluate the success and complication rates of percutaneous balloon valvuloplasty in a cohort of young patients with pulmonary valve stenosis.
• To identify factors associated with procedural failure and success.

Summary:

• Percutaneous balloon valvuloplasty was attempted in 41 pediatric patients with pulmonary valve stenosis.
• The procedure was effective in 33 patients, with complete success in 7 and partial success in 8 of those with tight stenosis.
• Failure occurred in 8 cases, predominantly in younger children (<1 year), due to technical issues or complications like air embolism or infundibular perforation.
• Accentuation of infundibular stenosis post-dilatation was a common cause of failure, though spontaneous improvement was observed in some cases.

Impact:

• Percutaneous balloon valvuloplasty is a viable treatment for pulmonary valve stenosis in children, though careful patient selection and monitoring are crucial.
• Understanding failure mechanisms, such as infundibular stenosis, can guide procedural improvements and patient management.
• This study contributes to the evidence base for interventional cardiology in pediatric congenital heart disease.