Ten Years of Experience in a Tertiary Center in Pulmonary Valvuloplasty in Pediatric and Adult Populations

Abstract

Background: The preferred treatment for isolated pulmonary valve stenosis is percutaneous balloon pulmonary valvuloplasty. The aim of our study was to evaluate the efficacy and short-term results of this procedure in pediatric and adult patients with pulmonary valve stenosis. Methods: In this retrospective case series, we reviewed the hospital records of pediatric and adult patients with a diagnosis of pulmonary valve stenosis subjected to balloon pulmonary valvuloplasty over a period of 10 years. Data regarding the immediate postprocedural findings as well as echocardiographic transvalvular pressure gradients after 6 months were recorded and analyzed. Results: Between 2003 and 2013, a total of 248 patients underwent balloon pulmonary valvuloplasty in our institution. Seventy-nine (31.8%) patients were < 18 years of age. The immediate success rate was 61%. However, the drop in right ventricular pulmonary artery pressure gradient was significantly more prevalent in the patients < 18 years old (73.1% in those < 18 y vs. 55.4% in those ≥ 18 y; P = 0.008). Regarding the success rate over 6 months after discharge, 75% of the patients < 18 years old and 79% of those ≥18 years old had transvalvular pressure gradients < 50% of the baseline transvalvular pressure gradients on echocardiography performed within 6 months after the initial procedure. Conclusions: In our case series, we demonstrated that balloon pulmonary valvuloplasty was an effective and safe method for the treatment of pulmonary valve stenosis in both pediatric and adult populations. However, there was a tendency toward a higher postprocedural pressure gradient in the older patients, which made the obstruction more difficult to regress.