Long-Term Results of Balloon Pulmonary Valvuloplasty

Background: The purpose of our study was to prove the hypothesis that balloon pulmonary valvuloplasty could effectively reduce valvular gradient ranged 30 to 50 mmHg to less than 30 mmHg in long-term follow-up. Methods: This cross-sectional study was performed on 271 consecutive patients aged 12 to 67 years who suffered from severe pulmonary stenosis who were scheduled for balloon pulmonary valvuloplasty at Shahid Rajaie Heart Center in Tehran between 2003 and 2013. Two years after the procedure, the patients were examined by transthoracic echocardiography and parameters related to pulmonary valve and right ventricular condition were reassessed. Among all 271 patients who were initially included into the survey, 37 patients (13.7%) had pulmonary valve gradient 30 to 50mmHgthat included our final targeted population for assessment. Results: Valvular gradient significantly dropped down from 93.1939.77mmHgto 38.7826.26 (P < 0.001). Among all 271 patients initially assessed, in two patients with valvular gradient less than 30 mmHg, the gradient remained unchanged long-term after procedure. In 37 patients with gradient ranged 30 to 50 mmHg before procedure, the gradient reduced to less than 30 mmHg in 32 patients with an overall rate of 86.5%, but remained in the same range in 4 patients and even increased to higher than 50 mmHg in 2 patients. There was a strong positive relationship between the change in valvular gradient and initial right ventricular systolic pressure (beta = 0.519, P < 0.001). Conclusions: Majority of patients with moderate pulmonic stenosis with gradient of 30 to 50 mmHg benefit from this procedure to achieve gradient less than 30 mmHg in long-term follow-up.