Original article Long-term Results of Percutaneous Balloon Valvuloplasty in Pulmonary Valve Stenosis in the Pediatric Population Raquel Merino-Ingelmo,* Jose ´ Santos-de Soto, Fe ´ lix Coserria-Sa ´ nchez, Alfonso Descalzo-Sen ˜ oran, and Israel Valverde-Pe ´ rez Unidad de Cardiologı´a y Hemodina ´mica Infantil, Hospital Virgen del Rocı´o, Seville, Spain Rev Esp Cardiol. 2014;67(5):374–379 Article history: Received 16 April 2013 Accepted 29 August 2013 Available online 5 February 2014 Keywords: Catheterization Valvuloplasty Pulmonary stenosis Congenital heart disease Follow-up studies Pediatrics Pulmonary regurgitation Right ventricle Echocardiography A B S T R A C T Introduction and objectives: Percutaneous pulmonary valvuloplasty is the preferred interventional procedure for pulmonary valve stenosis. The aim of this study was to evaluate the effectiveness of this technique, assess the factors leading to its success, and determine the long-term results in the pediatric population. Methods: The study included 53 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty between December 1985 and December 2000. Right ventricular size and functional echocardiographic parameters, such as pulmonary regurgitation and residual transvalvular gradient, were assessed during long-term follow-up. Results: Peak-to-peak transvalvular gradient decreased from 74 mmHg [interquartile range, 65-100 mmHg] to 20 mmHg [interquartile range, 14-34 mmHg]. The procedure was unsuccessful in 2 patients (3.77%). The immediate success rate was 73.58%. Follow-up ranged from 10 years to 24 years (median, 15 years). During follow-up, all patients developed late pulmonary regurgitation which was assessed as grade II in 58.4% and grade III in 31.2%. There was only 1 case of long-term restenosis (2.1%). Severe right ventricular dilatation was observed in 27.1% of the patients. None of the patients developed significant right ventricular dysfunction. Pulmonary valve replacement was not required in any of the patients. Conclusions: Percutaneous balloon valvuloplasty is an effective technique in the treatment of pulmonary valve stenosis with good long-term results. ß 2013 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. Resultados a largo plazo de la valvuloplastia transluminal percuta ´ nea en la estenosis valvular pulmonar en poblacio ´n pedia ´ trica Palabras clave: Cateterismo cardiaco Valvuloplastia Estenosis pulmonar Cardiopatı ´as conge ´ nitas Estudios de seguimiento Pediatrı ´a Insuficiencia pulmonar Ventrı ´culo derecho Ecocardiografı ´a R E S U M E N Introduccio ´n y objetivos: La valvuloplastia pulmonar percuta ´ nea se ha convertido en el tratamiento de eleccio ´n en los casos de estenosis valvular pulmonar. El objetivo de este estudio es evaluar la efectividad, determinar los factores predictores de e ´ xito y analizar los resultados a largo plazo en poblacio ´n pedia ´ trica. Me ´todos: El estudio comprende a 53 pacientes con estenosis valvular pulmonar sometidos a valvuloplastia percuta ´ nea en el periodo entre diciembre de 1985 y diciembre de 2000. En el control realizado a largo plazo, se analizaron para ´ metros ecocardiogra ´ ficos de taman ˜o y funcio ´n de ventrı ´culo derecho, presencia de insuficiencia pulmonar y el gradiente transvalvular pulmonar residual. Resultados: El gradiente transvalvular pulmonar disminuyo ´ de 74 [intervalo intercuartı ´lico, 65-100] a 20 [intervalo intercuartı ´lico, 14-34] mmHg. El procedimiento fue fallido en 2 pacientes (3,77%). La tasa de e ´ xito inmediato se situo ´ en el 73,58%. El tiempo de seguimiento mostro ´ una mediana de 15 [intervalo intercuartı ´lico, 10-24] an ˜os. Todos los pacientes en el seguimiento mostraban algu ´n grado de insuficiencia pulmonar, en el 58,4% de los casos de grado II y en el 31,2%, de grado III. Hubo un u ´ nico caso de reestenosis a largo plazo (2,1%), y tenı ´an dilatacio ´n ventricular derecha grave el 27,1% de los pacientes. Segu ´n los para ´ metros estudiados, no hubo casos de disfuncio ´n ventricular derecha significativa. No fue preciso el recambio valvular pulmonar en ninguno de los casos. Conclusiones: La valvuloplastia transluminal percuta ´ nea con cate ´ ter balo ´n es una te ´ cnica efectiva en el tratamiento de la estenosis valvular pulmonar, con buenos resultados a largo plazo. ß 2013 Sociedad Espan ˜ola de Cardiologı ´a. Publicado por Elsevier Espan ˜a, S.L. Todos los derechos reservados. * Corresponding author: Monte Carmelo 32 3. o A, 41011 Seville, Spain. E-mail address: raquel_merino_ingelmo@yahoo.es (R. Merino-Ingelmo). 1885-5857/$ – see front matter ß 2013 Sociedad Espan ˜ola de Cardiologı ´a. Published by Elsevier Espan ˜a, S.L. All rights reserved. http://dx.doi.org/10.1016/j.rec.2013.08.020 Document downloaded from https://www.revespcardiol.org/?ref=2031402403, day 17/02/2023. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Document downloaded from https://www.revespcardiol.org/?ref=2031402403, day 17/02/2023. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.