Key result
Pulmonary balloon valvuloplasty lowers peak pulmonary gradient by ~63% in infants, though mild regurgitation is common.
Why the study?
Few studies evaluate the long-term outcomes of valvuloplasty for pulmonary valve stenosis, especially the degree of pulmonary regurgitation.
Does pulmonary balloon valvuloplasty improve pulmonary gradients and limit pulmonary regurgitation in infants under 2 months with isolated pulmonary valve stenosis?
Cohort (n=78)
No
Does pulmonary balloon valvuloplasty improve pulmonary gradients and limit pulmonary regurgitation in infants under 2 months with isolated pulmonary valve stenosis?
Balloon pulmonary valvuloplasty is a safe and effective treatment for infants under 2 months with isolated pulmonary valve stenosis, providing sustained gradient reduction without severe pulmonary regurgitation.
Answers are grounded in this paper and cite their sources.
Supports monitoring for PR after infant BPV; leaves open predictors of progression in prospective cohorts.
Objectives: Pulmonary stenosis (PS) is a common congenital heart defect characterized by obstruction from the right ventricle to the pulmonary arteries.Few studies evaluate the long-term outcomes of the procedure, especially the degree of pulmonary regurgitation.We assessed the outcomes of infants following valvuloplasty for pulmonary valve stenosis. Methods:We conducted a retrospective analysis of children with pulmonary valve stenosis who underwent pulmonary balloon valvuloplasty (BPV) at a single institution.Clinical summaries, catheterization data, and echocardiographic data were reviewed.The inclusion criteria were isolated balloon pulmonary valvuloplasty for pulmonary valve stenosis, with age <2 months at the time of intervention.Results: Between 2006 and 2019, 104 patients underwent BPV for isolated PS.A total of 78 patients met the inclusion criteria.The median age at valvuloplasty was 6.5 days (1-60 days).The median last follow-up after valvuloplasty was 23.5±33.6 months.Pre-operative peak instantaneous pulmonary gradient (PIPG) measured by echocardiography was 70 (35-120) mmHg, which reduced to 26 (10-70) mmHg post-procedure.At the last follow-up, the gradient was 25 (0-100) mmHg.The mean balloon/ annulus ratio was 1.18±0.12.Concerning the development of pulmonary regurgitation, mild pulmonary regurgitation was most observed [in 36 patients (46%)], and no patient developed severe regurgitation.Additionally, a correlation was found between female gender, preoperative gradient, pulmonary valve structure, and high residual gradient (p<0.0001,R>700).Conclusion: Pulmonary balloon valvuloplasty remains a safe and effective treatment for children with isolated pulmonary valve stenosis, with excellent long-term outcomes and no mortality.Although the rate of reintervention is high in cases with a low mean balloon/annulus diameter ratio, the rate of pulmonary regurgitation is significantly lower.
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Utku Arman Örün (2023) conducted a cohort in Isolated pulmonary valve stenosis (n=78). Pulmonary balloon valvuloplasty was evaluated on Peak instantaneous pulmonary gradient (PIPG) and pulmonary regurgitation. Pulmonary balloon valvuloplasty in infants with isolated pulmonary stenosis reduced median peak pulmonary gradient from 70 mmHg to 26 mmHg post-procedure, with mild regurgitation occurring in 46%.
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