Open Access

ARTICLE

Medium-Term Results of Balloon Valvuloplasty of Native Pulmonary Valve Stenosis with and without Supravalvular Obstruction in Childhood

Olivia Lenoir^1,2, Daniel Quandt^1,2, Oliver Kretschmar^1,2, Walter Knirsch^1,2,*

1 Pediatric Cardiology, Pediatric Heart Center, Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland
2 University of Zurich, Zurich, Switzerland

* Corresponding Author: Walter Knirsch. Email:

Congenital Heart Disease 2022, 17(2), 161-172. https://doi.org/10.32604/chd.2022.016598

Received 30 March 2021; Accepted 19 August 2021; Issue published 26 January 2022

Abstract

Objectives: Factors influencing results of balloon valvuloplasty (BVP) of pulmonary valve stenosis (PS) in children are investigated. Background: BVP has become the standard of care for PS, medium-term results are not uniform and depend on various preconditions. Methods: We analysed the medium-term results of BVP of PS in children in an observational, single centre study. Need for additional procedure was defined as outcome after initial BVP. Results: We included 143 children (83 female) at a median (IQR) age of 2.6 (0.26–9.24) months and body weight of 5 (3.4–8) kg at BVP with a follow–up of 5.04 (1.6–10.2) years. We used balloon size of 10 (9–14) mm and maximal balloon pressure of 4 (3.5–10) atm, resulting in balloon–to–pulmonary annulus ratio of 1.28 (1.2–1.4). Systolic pressure gradient of PS was reduced with BVP (43.5 mmHg vs. 14.0 mmHg, p < 0.001) and confirmed by echocardiography (68.0 mmHg vs. 25.0 mmHg, p < 0.001) day 1 post procedure. Pulmonary BVP with associated supravalvular PS resulted in a relevant reduction of systolic pressure gradient in 23 of 31 patients (74.2%). Early additional procedure was necessary in 14 patients (9.8%) after 0.2 (0.1–0.7) years due to residual PS (n = 13) and infective endocarditis (n = 1). Factors for additional procedures were associated supravalvular PS with a higher residual pressure gradient, but not genetic syndrome. During further follow–up of 5.04 (1.6–10.2) years no further additional procedures were needed. Conclusions: Pulmonary BVP of native pulmonary valve stenosis leads to excellent medium-term results, even in 3 of 4 infants with associated supravalvular obstruction sufficient pressure relief can be obtained.

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