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Balloon pulmonary valvuloplasty in children, one year follow-up experience at Ramathibodi Hospital
P Khowsathit1, A Khositseth, B Pongpanich
1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Balloon pulmonary valvuloplasty is a safe and effective treatment for children with pulmonary valvular stenosis. This procedure significantly reduces pressure gradients, offering excellent intermediate-term results with no serious complications.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Congenital Heart Disease
Background:
- Pulmonary valvular stenosis is a common congenital heart defect.
- Balloon valvuloplasty is the preferred treatment for pulmonary valvular stenosis.
Purpose of the Study:
- To review the experience of balloon pulmonary valvuloplasty in children.
- To evaluate the efficacy and safety of the procedure over a 4-year period.
Main Methods:
- Retrospective review of 19 children undergoing pulmonary balloon valvuloplasty.
- Analysis of cardiac catheterization and Doppler echocardiography data.
- Assessment of pressure gradients before and after the procedure, with 1-4 year follow-up.
Main Results:
- Successful procedure in all 19 children.
- Significant reduction in peak systolic pressure gradient (catheterization: 92.05 to 34.26 mmHg; Doppler: 78.58 to 34.83 mmHg).
- Sustained gradient reduction at intermediate-term follow-up (23.05 mmHg).
Conclusions:
- Balloon pulmonary valvuloplasty is effective for pediatric pulmonary valvular stenosis.
- The procedure demonstrates excellent intermediate-term outcomes.
- No serious complications were reported, highlighting its safety profile.
Unlabelled:
Balloon valvuloplasty has become the treatment of choice in pulmonary valvular stenosis. The objective of this report is to review the experience of this procedure in children at the Department of Pediatrics, Ramathibodi Hospital in the past 4 years (1991-1994) with at least one year follow-up. During the study period, 19 children aged 2.1-14.3 years (mean 5.11 years) with the diagnosis of pulmonary valvular stenosis had successful pulmonary balloon valvuloplasty at this institution. The immediate peak systolic pressure gradient across the pulmonary valve by cardiac catheterization decreased from 92.05 +/- 46.92 to 34.26 +/- 25.30 mmHg, by Doppler from 78.58 +/- 26.55 to 34.83 +/- 15.60 mmHg. Peak pressure gradient across the pulmonary valve by Doppler of the last examinations, one to 4 years after the procedure (mean 1.9 years), was 23.05 +/- 9.40 mmHg in 17 patients. The mean ratio of balloon size and pulmonary valve ring was 1.06. One patient still has a residual gradient of 54 mmHg and two were lost to follow-up. No serious complication was encountered during the procedures.
Conclusion:
Balloon pulmonary valvuloplasty is effective in the management of children with valvular pulmonary stenosis. The intermediate term result is excellent.