Balloon pulmonary valvuloplasty of valvular stenosis in patients of the first year of life

Abstract

The aim – to determine the efficacy and to perform retrospective study of the results of balloon valvuloplasty in patients of the first year of life with isolated pulmonary artery stenosis.
Material and methods. During the period from January 1, 2007 to December 2014 the balloon valvuloplasty of the pulmonary valve was performed in 238 patients at the Ukrainian Pediatric Cardiology and Cardiac Surgery Center, among them 119 were males and 119 females. The median age of the patients was 42 (0; 365) days, the average
weight – 4.60 ±1.81 kg (1.7–11.4 kg). On average, before cath: systolic pressure in the right ventricle was (92.0±24.5) mm Hg; the gradient of systolic pressure on the valve of the pulmonary artery – (69.3±24.9) mm Hg; systolic pressure in the pulmonary artery was – (22.50±8.47) mm Hg.
Results. The procedure was effective in 223 (93.7 %) of 238 patients. Early mortality after balloon valvuloplasty was absent. Complications after balloon valvuloplasty occurred in 4 patients (1.68 %). The result of balloon valvuloplasty was suboptimal in 15 (6.3 %) patients. The mean follow-up period was 5.2±2.1 y (from 2 to 9.7 y). On average: the gradient of systolic pressure at the level of the pulmonary valve decreased from 69.3±24.9 to 20.6±13.4 mm Hg; systolic pressure in the right ventricle – from 92.0±24.5 to 48.2±13.8 mm Hg; the systolic pressure in the pulmonary artery increased from 22.50±8.47 mm Hg up to 27.60±8.65 mm Hg; the level of oxygenation of arterial blood increased from 90.80±9.32 % to 94.30±5.08 %. 29 (12.2 %) patients out of 238 required the repeated cardiac surgical interventions.
Conclusions. Balloon pulmonary valvuloplasty is an effective and safe method of x-ray endovascular treatment of isolated valve stenosis of the pulmonary artery.