Transluminal balloon valvotomy for pulmonic stenosis in an adult.

Transluminal balloon valvotomy has become a widely used nonsurgical approach to treatment of certain valvular lesions in children. In adults, however, experience with this technique is limited. We performed balloon valvotomy in a 61-year-old woman who had pulmonic stenosis. Four months after the procedure, her exercise tolerance had increased and she no longer had exertional dyspnea. Among the few reported cases of balloon valvotomy in adult patients with pulmonary stenosis, the systolic pressure gradient and the peak systolic ventricular pressure have been considerably reduced. Possible mechanisms by which transluminal balloon valvotomy relieves obstruction are tearing or deformation of the valve cusps, separation of fused commissures, fracture of valvular calcification, dilation of the annulus, or some combination of these factors. Balloon valvotomy seems to be an appropriate therapeutic choice for pulmonic stenosis in adult patients.