Open Access

ARTICLE

Long‐term outcomes up to 25 years following balloon pulmonary valvuloplasty: A multicenter study

Rachel L. Hansen^1,2, Iman Naimi³, Hongyue Wang¹, Nader Atallah^3,4, Frank Smith^3,4, Craig Byrum^3,4, Daniel Kveselis^3,4, Glenn Leonard^1,5, Rajiv Devanagondi¹, Matthew Egan^3,4

1 Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
2 Department of Pediatric Cardiology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
3 Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York
4 Department of Pediatric Cardiology, Pediatric Cardiology Associates of Central New York, Syracuse, New York
5 Department of Pediatric Cardiology, Pediatric Cardiology Associates of Western New York, Buffalo, New York

* Corresponding Author: Rachel L. Hansen, MD, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Box 21, Chicago, IL 60611. Email:

Congenital Heart Disease 2019, 14(6), 1037-1045. https://doi.org/10.1111/chd.12788

Abstract

Objective: Evaluate long‐term outcomes following balloon pulmonary valvuloplasty (BPV) for pulmonary stenosis (PS).
Background: Long‐term data following BPV is limited to small, single center studies.
Methods: BPV from April 12, 1985 to January 7, 2015 from three centers were included. Outcomes studied were ≥ moderate PI by echocardiogram and residual PS ≥ 40 mm Hg. Risk factors for ≥ moderate PI, residual PS, and repeat intervention were assessed by univariate and multivariate analysis.
Results: Among 254 patients, mean age at BPV was 3.8 years (range 1 day‐67 years), initial PS catheter gradient was 56 mm Hg (IQR 40‐70), 19% had critical PS, and 9% had genetic syndromes. Mean follow‐up duration was 7.5 years (maxi‐ mum 25 years). Sixty‐nine (29%) had ≥ moderate PI, 41 patients (17%) had residual PS > 40 mm Hg, and 31 (13%) had re‐intervention. In univariate analysis, younger age, lower weight, greater initial PS gradient, greater initial RV/systemic pressure ratio, critical PS, and longer follow‐up duration were associated with ≥ moderate PI. Greater initial PS gradient was associated with long‐term residual PS or repeat intervention. In multivariate analysis, greater initial gradient and lower weight were independently associated with > moderate PI and greater initial PS gradient and genetic abnormality were independently associated with residual PS and repeat intervention.
Conclusion: Smaller patients with greater initial PS were more likely to develop sig‐ nificant long‐term PI. Patients with greater initial PS and genetic abnormalities were more likely to have residual PS or require repeat intervention following BPV.

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