Factors Determining Immediate and Medium-Term Results after Pulmonary Balloon Valvuloplasty(cid:31)
Suchaya Silvilairat MD*, Yupada Pongprot MD*, Rekwan Sittiwangkul MD*, Charlie Phornphutkul MD*
Affiliation : (cid:31) Presentation: 54th Thai Congress of Pediatrics, The Royal College of Pediatricians and Pediatric Society of Thailand, April 24-26, 2002 * Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objective : To determine factors influencing immediate and medium-term results of Pulmonary Balloon Valvu-
loplasty (PBV) for pulmonary valve stenosis.
Materials and Methods : Between 1995 and 2001, the authors carried out PBV in 25 consecutive patients. Two
treatment outcomes including immediate and medium-term results were analyzed. The immediate results were
classified into two groups based on the pulmonary systolic pressure gradient (PG) immediately after dilation:
group I with a PG < 35 mmHg and group II with a PG > 35 mmHg. At medium-term follow-up of 6 to 60 months,
echocardiographic evaluations were analyzed and divided into two groups: group A with a PG < 25 mmHg
and group B with a PG > 25 mmHg. Demographic characteristics and hemodynamic parameters of immediate
and medium-term results were compared and analyzed.
Results : Immediately after PBV, the right ventricular systolic pressure (RVSP) decreased from 115.3 (cid:31) 37.6
mmHg to 67.0 (cid:31) 28.5 mmHg (p < 0.001). The pulmonary systolic pressure gradient decreased from 90.4 (cid:31) 37.9
mmHg to 39.3 (cid:31) 25.6 mmHg (p < 0.001). Nine of the 25 patients (group II; 36%), with incomplete immediate
relief of the obstruction, had more symptoms, a higher baseline PG, higher right atrial pressure, higher RVSP,
and a higher systolic pressure ratio. Six of the 25 patients (group B; 24%), with suboptimal medium-term
results, had a higher right ventricular voltage on the electrocardiogram, higher pre-dilation PG, and higher
RVSP.
Conclusion : Successful medium-term outcomes following pulmonary balloon valvuloplasty were achieved in
76% of the patients, with a greater success rate (91%) in patients with a lower right ventricular voltage
electrocardiogram (R wave amplitude in V1) < 21 mm, a prevalvuloplasty systolic gradient < 90 mmHg, and
right ventricular systolic pressure < 125 mmHg.
Keywords : Pulmonary valve stenosis, Valvuloplasty, Outcome
