Ajith Ananthakrishna Pillai1, Vidhyakar Rangasamy Balasubramonium1, Harichandrakumar Kottyen Thazhath2, Maheshkumar Saktheeshwaran1, Raja Selvaraj1, Santhosh Satheesh1, Balachander Jayaraman1
1Department of Cardiology, 2Department of Medical Biometrics and Informatics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Background and aim of the study: The study aim was to determine the immediate and long-term outcomes of balloon pulmonary valvuloplasty (BPV) in a large cohort of adult patients (aged ≥18 years) with congenital valvular pulmonic stenosis.
Methods: A retrospective data analysis was conducted of the immediate and long-term outcomes of adult patients who had undergone BPV between 2000 and 2012 at a single tertiary care center.
Results: A total of 132 patients (mean age 27.7 years; 95% CI 21.12-34.76) underwent BPV, with a mean follow up period of 5.7 years (95% CI 4.37-6.98). Intervention resulted in successful BPV (>50% reduction in baseline gradient) in 124 patients (94%), and a partially successful BPV (20-50% reduction in baseline gradient) in eight patients (6%). The mean right ventricular (RV) systolic pressure was decreased from 90.6 mmHg (95% CI
84.90-96.33) to 50.9 mmHg (95% CI 47.17-54.61) (p <0.001), and the pulmonary valve (PV) gradient was reduced from 70.7 mmHg (95% CI 65.12-76.22) to 29.0 mmHg (95% CI 25.83-32.23) (p <0.001). The mean percentage difference in PV gradient in both genders was 60.23% in males and 57.44% in females (95% CI 55.33-65.12 and 55.32-61.56, respectively) (p >0.05). Pulmonary valve regurgitation was reported in 17.4% of patients, and was not related to either successful outcome or balloon size. The gradient reductions were maintained after five and 10 years of follow up. Two patients (1.5%) developed restenosis that required repeat BPV. There was no referral for urgent surgery.
Conclusion: BPV in adults produced excellent long-term clinical results, there being no gender-related difference in outcome. In addition, the need for reintervention was very low.
The Journal of Heart Valve Disease 2014;23:511-515
|Balloon Pulmonary Valvuloplasty in Adults: Immediate and Long-Term Outcomes|
Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.
Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.