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20 years follow-up results of pulmonary balloon valvuloplasty in adults and the fate of concomitant severe infundibular stenosis and severe tricuspid regurgitation
  1. ME Fawzy,
  2. S El Amraoiu,
  3. O Nowayhed,
  4. I Ibrahim,
  5. S Shah,
  6. H Al Sergani
  1. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

Abstract

Objectives The goal of this study was to evaluate the long-term (up to 20 years) outcome of pulmonary balloon valvuloplasty (PBV) for severe pulmonary valve stenosis in adults, and to determine its effects on concomitant severe infundibular stenosis and severe tricuspid regurgitation.

Methods PBV was performed in 90 consecutive patients (49 women) mean age 23 ± 9 years with severe congenital pulmonary valve stenosis. Clinical and echocardiographic assessment were performed 2–20 years (mean 11 ± 3.3) after PBV. Repeat cardiac catheterisation was performed 6–24 months after PBV in 43 patients who had concomitant moderate to severe infundibular stenosis (infundibular gradient >30 mm Hg).

Results There were no immediate or late deaths. The mean catheter peak pulmonary gradient before and immediately after PBV was 105 ± 39 and 34 ± 26 (p<0.0001). The right ventricular pressure was 125 ± 38 and 59 ± 21 mm Hg, respectively (p<0.0001). The infundibular gradient (in 43 patients) immediately after PBV was 42.9 ± 24.8 (30–113) mm Hg and regressed at repeated catheterisation to 13.5 ± 8.3 mm Hg (p<0.0001). Doppler peak pulmonary gradient before PBV and at one year and long-term follow-up was 91 ± 33 (range 36–200), 28 ± 12 (p<0.0001) and 26±11 mm Hg (p = 0.2), respectively. New mild pulmonary regurgitation was noted in 24 patients (28%) after PBV. Significant tricuspid regurgitation in seven patients either regressed or disappeared after PBV.

Conclusions Long-term results up to 20 years of PBV in adults are excellent. Severe infundibular stenosis and severe tricuspid regurgitation regressed after successful PBV. No restenosis was encountered after successful PBV.

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