The Journal of heart valve disease · 2014
Balloon pulmonary valvuloplasty in adults: immediate and long-term outcomes.
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Ananthakrishna Ajith, Balasubramonium Vidhyakar Rangasamy, Thazhath Harichandrakumar Kottyen, Saktheeshwaran Maheshkumar, Selvaraj Raja, Satheesh Santhosh, Jayaraman Balachander
Аннотация
BACKGROUND AND AIM OF THE STUDY: The study aim was to determine the immediate and long-term outcomes of balloon pulmonary valvuloplasty (BPV) in a large cohort of adult patients (aged ≥ 18 years) with congenital valvular pulmonic stenosis.
METHODS: A retrospective data analysis was conducted of the immediate and long-term outcomes of adult patients who had undergone BPV between 2000 and 2012 at a single tertiary care center.
RESULTS: A total of 132 patients (mean age 27.7 years; 95% CI 21.12-34.76) underwent BPV, with a mean follow up period of 5.7 years (95% CI 4.37-6.98). Intervention resulted in successful BPV (> 50% reduction in baseline gradient) in 124 patients (94%), and a partially successful BPV (20-50% reduction in baseline gradient) in eight patients (6%). The mean right ventricular (RV) systolic pressure was decreased from 90.6 mmHg (95% CI 84.90-96.33) to 50.9 mmHg (95% CI 47.17-54.61) (p < 0.001), and the pulmonary valve (PV) gradient was reduced from 70.7 mmHg (95% CI 65.12-76.22) to 29.0 mmHg (95% CI 25.83-32.23) (p < 0.001). The mean percentage difference in PV gradient in both genders was 60.23% in males and 57.44% in females (95% CI 55.33-65.12 and 55.32-61.56, respectively) (p > 0.05). Pulmonary valve regurgitation was reported in 17.4% of patients, and was not related to either successful outcome or balloon size. The gradient reductions were maintained after five and 10 years of follow up. Two patients (1.5%) developed restenosis that required repeat BPV. There was no referral for urgent surgery.
CONCLUSION: BPV in adults produced excellent long-term clinical results, there being no gender-related difference in outcome. In addition, the need for reintervention was very low.
METHODS: A retrospective data analysis was conducted of the immediate and long-term outcomes of adult patients who had undergone BPV between 2000 and 2012 at a single tertiary care center.
RESULTS: A total of 132 patients (mean age 27.7 years; 95% CI 21.12-34.76) underwent BPV, with a mean follow up period of 5.7 years (95% CI 4.37-6.98). Intervention resulted in successful BPV (> 50% reduction in baseline gradient) in 124 patients (94%), and a partially successful BPV (20-50% reduction in baseline gradient) in eight patients (6%). The mean right ventricular (RV) systolic pressure was decreased from 90.6 mmHg (95% CI 84.90-96.33) to 50.9 mmHg (95% CI 47.17-54.61) (p < 0.001), and the pulmonary valve (PV) gradient was reduced from 70.7 mmHg (95% CI 65.12-76.22) to 29.0 mmHg (95% CI 25.83-32.23) (p < 0.001). The mean percentage difference in PV gradient in both genders was 60.23% in males and 57.44% in females (95% CI 55.33-65.12 and 55.32-61.56, respectively) (p > 0.05). Pulmonary valve regurgitation was reported in 17.4% of patients, and was not related to either successful outcome or balloon size. The gradient reductions were maintained after five and 10 years of follow up. Two patients (1.5%) developed restenosis that required repeat BPV. There was no referral for urgent surgery.
CONCLUSION: BPV in adults produced excellent long-term clinical results, there being no gender-related difference in outcome. In addition, the need for reintervention was very low.