Percutaneous Balloon Valvuloplasty for the Treatment of Pulmonary Valve Stenosis in Children : A Single Centre Experience

Isolated pulmonary valve stenosis (PVS) is a common heart defect (6-9%); the preferred treatment is balloon pulmonary valvuloplasty (BPV). This study aims to assess BPV results in children with isolated PVS treated at the pediatric cardiac catheterization unit, Sohag University Hospital in the period between 2009 and 2012. The studied group consisted of 63 children (37 males and 26 females), aged 29±28 months. The diagnosis of isolated pulmonary stenosis was based on physical examination, ECG, chest radiograph, echocardiography, haemodynamic and angiocardiographic studies. The patients were divided into two groups, depending on successful or unsuccessful procedure. The balloon diameter to pulmonary valve annulus ratio in the two groups was 1.29 ± 0.16, and 1.42 ± 0.13 respectively. Results of our study revealed that patients showed significantly decreased pressure gradient across PVS immediately post-BPV (85.58 ± 15.9 mmHg to 17 ± 13 mmHg) (p < 0.001). The procedure was ineffective only in eight (12.7%) children of whom five had re-BPV and three were operated on. Subpulmonary stenosis was seen in 4.8% of children pre-BPV; in 15% post-BPV and in only 3.5% at the end of follow-up. Complications were seen in two (3.2%) patients including one case of a balloon being lodged in the iliac vein (surgical repair) and another patient had perforation of RV during contrast injection with moderate pericardial effusion which resolved spontaneously. Follow-up echocardiography results were similar to those of immediate post BPV values of pressure gradients across PVS. Pulmonary regurgitation > II increased from 2.2% before to 24% after BPV. These medium-term follow-up data confirm efficacy and safety of BPV in children with isolated PVS.