Pulmonary Regurgitation After Balloon Valvuloplasty in Children With Pulmonary Stenosis



Ghaderian M¹ ; Meraji M¹ ; Arabi Moghadam MY¹ ; Keikha M² Show Affiliations
Source: Tehran University Medical Journal Published:2014

Abstract

Background: Pulmonary valve stenosis (PS) is one of the most common congenital heart disease in children. Isolated pulmonary stenosis is the most common form of pulmonary stenosis. Isolated Pulmonary stenosis is responsible for 8 to 10 percent of congenital heart disease. Balloon valvuloplasty is the choice of treatment for this cardiac disease. One of the most important complications of this disease is pulmonary regurgitation in follow-up. The purpose of this study was to characterize the status of pulmonary regurgitation on follow-up after pulmonary valvuloplasty by balloon. Methods: We studied pulmonary regurgitation after balloon valvuloplasty retrospectively in children less than 14 years old age and isolated pulmonary stenosis. These patients had not complex congenital heart disease and admitted for balloon valvuloplasty during period of September 2001 to September 2011 in Shahid Rajaee Cardiovascular Research Center. The mean time of follow-up was 7±2.5 years. Results: Four hundred and fifty-eight patients with mean age of 10.3±8.6 months were studied. Two hundred and fifty-five patients were male and 230 were female. Right ventricular pressure was decreased from 82.3±42.2 mmHg before procedure to 45.2±22.4 mmHg after procedure (P= 0.043). Pressure gradient between right ventricle and pulmonary artery was decreased from 75.4±18.2 mmHg to 25.7±15.13 mmHg during procedure (P= 0.032). The day after procedure, 180 (37.1%) patients had no pulmonary regurgitation echocardiographic evaluation, 175 (36.08%) had mild, and 118 (24.3%) had moderate pulmonary regurgitation. In patients with moderate pulmonary regurgitation, 7 (0.14%) of those improve to severe pulmonary regurgitation. In echocardiographic exam, 12 (2.4%) patients had severe regurgitation the day after balloon valvuloplasty. During long-term follow-up (7±2.5 years) for 3 patient pulmonary valve replacement were performed. In our study, balloon to annulus ratio in three groups of pulmonary regurgitation (mild, moderate and sever) had significant correlation (P= 0.012). Conclusion: Pulmonary regurgitation was seen after balloon valvuloplasty in some patients. In most patients it had no symptoms and long-term follow-up is necessary. © 2014, Tehran University of Medical Sciences. All rights reserved.