Key result
Balloon pulmonary valvuloplasty provides durable stenosis relief, though late pulmonary insufficiency develops in up to ~60%.
Why the study?
Long-term outcomes and associated risk factors after percutaneous balloon pulmonary valvuloplasty for isolated pulmonary valve stenosis in pediatric populations remain incompletely characterized.
What are the long-term outcomes and predictors of restenosis, reintervention, and pulmonary insufficiency following percutaneous balloon pulmonary valvuloplasty in pediatric patients with isolated valvular pulmonary stenosis?
Systematic Review (n=1,505)
What are the long-term outcomes and predictors of restenosis, reintervention, and pulmonary insufficiency following percutaneous balloon pulmonary valvuloplasty in pediatric patients with isolated valvular pulmonary stenosis?
Percutaneous balloon pulmonary valvuloplasty provides excellent long-term relief of isolated pulmonary stenosis in pediatric patients with low mortality and reintervention rates, though late pulmonary insufficiency is a common sequela.
Supports BPV as durable first-line therapy for pediatric pulmonary stenosis; extends long-term data on low reintervention but frequent pulmonary insufficiency.
Percutaneous Balloon Pulmonary Valvuloplasty (BPV) is the gold standard treatment for isolated pulmonary valve stenosis in the pediatric population. However, its long-term outcomes and associated risk factors remain incompletely characterized. This systematic review aimed to assess BPV long-term outcomes and predictors for restenosis/reintervention and pulmonary insufficiency (PI) following BPV in this population. PubMed, Scopus, Web of Science and Cochrane databases were searched to identify studies including pediatric populations with a minimum follow up of five years after BPV (ranging up to 20 years). Fifteen studies were included, comprising 1505 patients. BPV was associated with sustained relief of pulmonary valve stenosis and low procedure-related and late mortality (ranges 0-4.2% and 0-6%, respectively). Restenosis occurred in a minority of patients, (range 0-38%), and reintervention was uncommon (median rates: repeat BPV 5.0%, surgery 4.5%). Both were consistently associated with unfavorable hemodynamic characteristics including a higher initial transvalvular pulmonary gradient or a higher right ventricular overload and residual obstruction after the procedure, as well as unfavorable anatomical characteristics including a smaller pulmonary valve annulus size. PI was the most frequently late outcome identified (range 5.6%-60%), and was predominantly associated with younger age at intervention, lower body weight and greater severity of stenosis at baseline. Pulmonary valve replacement remained uncommon during follow-up (range 0-12.3%, median 1.4%). These results highlight the differential impact of anatomical, hemodynamic and procedural factors on long-term outcomes after BPV in pediatric patients. Due to substantial heterogeneity in outcome definitions and gradient assessment methods, results were synthesized narratively.
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Pereira et al. (2026) conducted a systematic review in Pediatric isolated valvular pulmonary stenosis (n=1,505). Percutaneous Balloon Pulmonary Valvuloplasty was evaluated on Restenosis, reintervention, and clinically significant pulmonary insufficiency. Percutaneous balloon pulmonary valvuloplasty provided sustained relief of pulmonary stenosis with low restenosis (0-38%), though pulmonary insufficiency was a frequent late outcome (5.6-60%).
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