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KMID : 0311120080490030416
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Yonsei Medical Journal
2008 Volume.49 No. 3 p.416 ~ p.421
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Major Determinants and Long-Term Outcomes of Successful Balloon Dilatation for the Pediatric Patients with Isolated Native Valvular Pulmonary Stenosis: A 10-Year Institutional Experience
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Lee Meng-Luen
Peng Jui-Wen
Tu Guo-Jhueng
Chen San-Yi
Lee Jyong-You
Chang Shu-Lin
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Abstract
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Purpose: We report herein major determinants and long-term outcomes of balloon dilatation (BD) for 27 pediatric patients with isolated native valvular pulmonary stenosis (VPS).
Materials and Methods: From May 1997 to May 2003, 27 pediatric patients with VPS (pressure gradients ≥ 40mmHg) were enrolled in this retrospective study. Single-balloon maneuver was applied in 26 patients, and double-balloon maneuver in 1. After BD, the pressure gradients were documented simultaneously by pullback maneuver by cardiac catheterization and echocardiography within 24 hours, at 1-month, 3-month, 1-year, and 4-to-10-year follow-ups.
Results: Before BD, the echocardiographic gradients ranged from 40 to 101mmHg (61 ± 19, 55), and from 40 to 144mmHg (69 ± 32, 60) by pressure recordings. After BD, the gradients ranged from 12 to 70mmHg (29 ± 13, 27) by pressure recording (p < 0.001), and from 11 to 64mmHg (27 ± 12, 26) by echocardiography within 24 hrs (p < 0.001). The ratios of the systolic pressure of the right ventricle to those of the left ventricle were 55 to 157% (89 ± 28, 79%) before BD, and 30 to 79% (47 ± 13, 42%) after BD (p < 0.001). Follow-up (7.7 ± 5.7, 4.5 years) echocardiographic gradients ranged from 11 to 61mmHg (25 ± 11, 24). Two patients did not have immediate success owing to infundibular spasm. Improved right ventricular compliance could be accounted for the ultimate success in these 2 patients. The ultimate successful rate was 100%.
Conclusion: BD can achieve excellent long-term outcomes in the pediatric patients with isolated native VPS.
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KEYWORD
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Balloon dilatation, pediatric, valvular pulmonary stenosis
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