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Balloon dilatation in infants and children with dysplastic pulmonary valves: short-term and intermediate-term results
1Department of Pediatrics, King Faisal Specialist Hospital and Reasearch Center, Riyadh, Saudi Arabia.
Insights
Balloon valvuloplasty effectively reduces pulmonary valve gradients in patients with and without dysplastic pulmonary valves. Dysplastic valves do not appear to cause recurrent stenosis after this pulmonary stenosis treatment.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Dysplastic pulmonary valves can lead to pulmonary stenosis.
- Recurrence of stenosis after balloon valvuloplasty is a concern.
- Understanding the role of valve dysplasia in outcomes is crucial.
Purpose of the Study:
- To evaluate the efficacy of balloon valvuloplasty in patients with dysplastic pulmonary valves.
- To determine if dysplastic pulmonary valves contribute to restenosis after the procedure.
Main Methods:
- Retrospective analysis of balloon valvuloplasty outcomes.
- Comparison of patients with and without dysplastic pulmonary valves.
- Assessment of pulmonary valve gradients and right ventricular pressures before and after the procedure, and during follow-up.
Main Results:
- Balloon valvuloplasty significantly reduced pulmonary valve gradients in both groups (dysplastic vs. non-dysplastic).
- Immediate and follow-up gradients and pressures were similar between groups.
- No significant difference in outcomes was observed based on the presence of valve dysplasia.
Conclusions:
- Balloon valvuloplasty is an effective treatment for pulmonary stenosis, regardless of pulmonary valve morphology.
- Dysplastic pulmonary valves do not appear to be a significant factor in the recurrence of stenosis post-valvuloplasty.
Abstract:
This study was designed to document the results of balloon valvuloplasty in patients with dysplastic pulmonary valves and to determine whether dysplastic pulmonary valves are responsible for recurrence of stenosis after balloon pulmonary valvuloplasty. Balloon valvuloplasty in 13 patients, aged 6 days to 12 years (median 1 year), with dysplastic pulmonary valves reduced the pulmonary valve gradient from 77.2 +/- 44.2 (mean +/- SD) to 26.8 +/- 17.0 mm Hg (p less than 0.001), which remained improved (34.9 +/- 34.6 mm Hg; p less than 0.02) at 6 to 19 months' (mean 10 months) follow-up. Valvuloplasty in 43 patients without dysplastic pulmonary valves reduced the valvar gradient from 94.3 +/- 41.0 to 31.1 +/- 22.4 mm Hg (p less than 0.001) immediately after the procedure, which at 6 to 34 months' follow-up in 23 patients was 29.2 +/- 33.5 mm Hg (p less than 0.001). The right ventricular peak systolic pressures (96.2 +/- 43.3 vs 112.1 +/- 40.1 mm Hg) and pulmonary valvar gradients (77.2 +/- 44.2 vs 94.3 +/- 41.0 mm Hg) before valvuloplasty, residual right ventricular pressures (52.9 +/- 14.5 vs 56.1 +/- 24.2 mm Hg) and pulmonary valvar gradients (26.8 +/- 17.0 vs 31.1 +/- 22.4 mm Hg) immediately after valvuloplasty, and residual right ventricular pressures (59.3 +/- 30.3 vs 53.6 +/- 34.3 mm Hg) and pulmonary valvar gradients (34.9 +/- 34.6 vs 29.2 +/- 33.5 mm Hg) at follow-up catheterization were similar (p greater than 0.1) in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)