[Pulmonary balloon valvulotomy. The results in 42 cases]

Area of Science:

• Cardiology
• Interventional Cardiology
• Pediatric Cardiology

Background:

• Congenital pulmonary stenosis is a significant cause of right ventricular outflow tract obstruction.
• Percutaneous balloon valvulotomy has emerged as a primary treatment for isolated pulmonary stenosis.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous balloon valvulotomy for congenital pulmonary stenosis.
• To assess the impact of infundibular obstruction on procedural outcomes.

Main Methods:

• Retrospective analysis of 42 patients with congenital pulmonary stenosis undergoing balloon valvulotomy.
• Measurement of pressure gradients before and after the procedure using Doppler echocardiography.
• Stratification of patients into groups with and without reactive infundibular obstruction.

Main Results:

• A significant reduction in the total basal pressure gradient from 82.9 +/- 40.6 mm Hg to 31.2 +/- 27.1 mm Hg (p < 0.00001) was observed.
• Patients without infundibular obstruction showed a gradient reduction from 71.6 +/- 33.5 to 18.9 +/- 11.2 mm Hg (p < 0.00001).
• Patients with infundibular obstruction also experienced a significant reduction in total gradient (p = 0.002), with those treated with propranolol showing progressive gradient reduction over follow-up.

Conclusions:

• Percutaneous balloon valvulotomy is a safe and effective treatment for valvular pulmonary stenosis with low restenosis rates.
• Optimal balloon sizing (balloon diameter/pulmonary annulus ratio of 1.2 to 1.5) is crucial for successful outcomes.
• The procedure yields good results even in the presence of infundibular obstruction, particularly with appropriate medical management.