OUTCOME OF BALLOON PULMONIC VALVULOPLASTY WITH 18 MONTHS FOLLOW UP
AbstractObjective: To determine the immediate and intermediate term outcome of balloon pulmonicvalvuloplasty by echocardiography. Methods: This study was conducted in the Department ofCardiology Postgraduate Medical Institute Lady Reading Hospital (LRH), Peshawar from July 1999 toJanuary 2003. Patients with severe pulmonic valve stenosis who underwent balloon pulmonicvalvuloplasty during this period were included in the study. Forty Patients fulfilling the study inclusioncriteria were followed up to 18 months by two dimensional and Doppler echocardiographicexaminations at 6 months interval. Patients with dysplastic valve leaflets or for whom 18 months followup data was not available were excluded from the study. Echocardiographic data was collectedprospectively. Echocardiographic hemodynamic data was analysed initially and at all three follow upvisits, using descriptive statistics and paired t-test. Results: Total 64 balloon pulmonic valvuloplastyprocedures were performed during this period. Forty patients fulfilled the study inclusion criteria andthe remaining 24 patients were excluded from the study. Mean age of the patients was 13.05±8.22years, ranging from 1–33 years. Pre-peak pulmonic valve gradient reduced from 100.9±29.20 mmHg to31.38±15.99 mmHg (p<0.0001) immediately after balloon pulmonic valvuloplasty. Pulmonic valvegradient at day 1 (31.38±15.99) reduced significantly at 18 months (18.88±10.24) (p<0.0001).Complication encountered during the procedure was transient ventricular tachycardia or multiplepremature ventricular contractions. Conclusion: Balloon pulmonic valvuloplasty is safe and effectivein reducing pulmonic valve gradient acutely and the benefit persists till 18 months. Further fall inpulmonic valve gradient is seen in intermediate term follow up.Keywords: Pulmonic valve stenosis, balloon pulmonic valvuloplasty
Bashore TM. Adult Congenital heart diseases: right ventricular
outflow tract lesions. Circulation 2007;115:1933–47.
Bonow Ro, Carabello BA, Chatterjee K, de leon Ac Jr, Faxon
DP, Freed MD, et al. ACC/AHA 2006 guideline for the
management of patients with vauvular heart diseases: executive
summary.(committee on management of patients with valvular
Heart Disease) Circulation 2007;116:1736–54.
Rao PS. Galal O, Patnana M, Buck SH, Wilson AD. Results of
three to 10 year flow-up of balloon dilation of the pulmonary
valve. Heart 1998;80:591–5.
J Ayub Med Coll Abbottabad 2009;21(3)
CAC Pedra, J Haddad, SF Pedra, A Peirone, CB Pilla, and JA
marin Neto. Paediatric and congenital heart diseases in South
America: an overview. Heart 2009;95:1385–92.
Hellnbrand WE, Allen HD, Golike RJ, Lutin W, Kanj S.
Ballon pulmonary valvuloplasty and angioplasty of congenital
anomalies registry. Am J Cardiol 1990;65:793–7.
Khan MM, Yousef SA, Muslins CE. Percutaneous transluminal
balloon pulmonary valvuloplasty for the relief of pulmonary
valve stenosis with special reference to double balloon
technique. Am Heart J 1986;112:158–66.
Lasab SA, Ribeiro P, Zaibag MA. Use of a double balloon
technique for percutaneous balloon pulmonary valvatomy in
adult. Br Heart J 1987;58:136–41.
Garty Y, Veldtman G, Lee K, Benson L. Late outcome after
pulmonic valve balloon dilatation in neonates, infants and
children. J Invasive Cardiol 2005;17:318–22.
Bader R. Percutaneous Pulmonary valvuloplasty for the relief of
pulmonary valve stenosis in children: Does the technique effect
the long term results? J Saudi Heart Assoc 2002;14:97–100.
Abu Haweleh A, Hakim F. Balloon pulmonary vulvoplasty in
children: Jordanian experience. J Saudi Heart Assoc
Robertson M, Benson LN, Smallhorn JS, Musewe N, Freedom
RM, Moes AF. The morphology of right ventricle outflow tract
after percutaneous pulmonary valvatomy: Long-term follow-up
Br Heart J 1987;58:239–44.
Schmaltz AA, Bein G, Graving hoff L, Hagel K, Hentrich F,
Hofs tetter R. Balloon pulmonary valvuloplasty in infants and
children Co-operative study of German society of Pediatric
cardiology. Eur Heart J 1989;10:967–71.
Rao PS, Fawzy ME, Solymar L. Long-term results of balloon
pulmonary valvuloplasty of vavular pulmonic stenosis. Am
Heart J 1988;115:1291–6.
Gupta D, Sexena A, Kothari SS, Juneja R. Factors influencing
late course of residual valvular and infundibular gradients
following pulmonary valve balloon delation. Int J Cardiol
Kaul UA, Singh B, Tyagi S. Long-term results after balloon
pulmonary valvuloplasty in adults. Am Heart J 1993;5:1152–5.
Mohammad EF, Mohammad A, Omar G. Long-term Results of
pulmonary Baloon valvulotomy in adult patients. Journal of
Heart valve Diseases 2001;10:150–62.
Burch M Sharland M, Shinebourne. Cardiologic abnormalities
in Noonan syndrome: Phenotypic diagnosis and
echocardiographic assessment of 118 patient. J Am Coll
Witsen burg M, Talsma M, Rohmer J. Balloon valvuloplasty
for valvular pulmonary stenosis in children over 6 months of
age: Initial results and long-term follow-up. Eur Heart J
Narang R, Das G, Dev V, Goswanmi K, Saxena A, Shrivasava
S. Effect of the balloon annulus ratio on the intermediate and
follow up results of pulmonary balloon valvuloplasty.
Jarrar M, Betbout F, Farhat MB, Maatouk F, Gamra H, Adad F
et al. Long-Term invasive and noninasive results of
percutaneous balloon pulmonary valvuloplasty in children,
adolescents and adult. Am Heart J 1999;138:950–4.
Gildein HP, Kleinert S, Goh TH, Wilkinson JL. Treatment of
Critical pulmonary valve stenosis by balloon dilation in the
neonates. Am Heart J 1996;131:1007–11.
Sharieff S, Shah-e-Zaman K, Faruqui AM. Short and
intermediate-term follow-up results of percutaneous
transluminal balloon valvuloplasty in adolescents and young
adult with congenital pulmonary valve stenosis. J Invasive
Talsma M, Witsenberg M, Rohmes J, Hess J. Determinants for
outcome of balloon valvuloplasty for severe pulmonary
stenosis in neonates and infants upto six months of age. Am J
Fawzy ME, Hassan W, Fadel MB, Sergani H, El Shaer. Long
term results (up to 17 years) of pulmonary balloon
valvuloplasty in adults and its effect on concomitant sever
infundibular stenosis and tricuspid regurgitation. Am Heart J
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