[Percutaneous pulmonary valvuloplasty in children and adults: immediate results]

Between April 1987 and December 1993, 60 consecutive patients with valvular pulmonary stenosis underwent percutaneous balloon valvuloplasty in the cardiology department of Monastir. The average age was 13.9 +/- 10.9 years (3 days-44 years). Fifteen patients were over 17 years of age and 4 were less than one year old. The right ventricular systolic pressure fell from 116.5 +/- 39.5 mmHg to 55 +/- 19.7 mmHg (p < 0.0001) immediately after the procedure. The peak-to-peak systolic gradient between the right ventricle and pulmonary artery fell from 95.4 +/- 40.2 mmHg to 30.4 +/- 19.0 mmHg (p < 0.00001), the valvular-gradient fell from 87.5 +/- 39.6 mmHg to 14.7 +/- 11.1 mmHg (p < 0.00001) and the infundibular pressure gradient increased slightly from 8.0 +/- 14.0 mmHg to 15.6 +/- 18.6 mmHg (p = 0.06). The systolic pulmonary artery pressure increased from 21.6 +/- 6.0 mmHg to 25.2 +/- 6.3 mmHg (p = 0.0015). The mean pulmonary artery pressure from 15.6 +/- 4.8 mmHg to 17.3 +/- 4.9 mmHg (p = 0.028). There were no changes in pulmonary diastolic pressures (10.6 +/- 3.7 mmHg vs 9.2 +/- 3.5 mmHg, p = 0.6). There were 4 primary failures (6.4%) with residual valvular gradients > or = 30 mmHg, including one due to valvular dysplasia. No predictive factors of primary failure could be identified. An infundibular gradient > or = 20 mmHg was observed in 11 patients, 4 of whom had gradients > or = 50 mmHg (6.6%); two gradients were residual and 2 were created by pulmonary valvuloplasty.(ABSTRACT TRUNCATED AT 250 WORDS)