Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1985 Oct;54(4):435–441. doi: 10.1136/hrt.54.4.435

Percutaneous balloon valvuloplasty for pulmonary valve stenosis in infants and children.

I D Sullivan, P J Robinson, F J Macartney, J F Taylor, P G Rees, C Bull, J E Deanfield
PMCID: PMC481923  PMID: 2932133

Abstract

Pulmonary valve stenosis was relieved by balloon dilatation during cardiac catheterisation on 27 occasions in 23 infants and children aged 7 days to 12 years, median 31 months (three aged less than 2 weeks). Pulmonary valve diameter was estimated by cross sectional echocardiography to assist in the choice of balloon size. Before dilatation the right ventricular systolic pressure ranged from 41 to 190 (median 92) mm Hg and was suprasystemic in 10 patients. There were significant reductions in the ratio of right ventricular to systemic systolic pressure and pulmonary systolic pressure gradients immediately after balloon dilatation. Twelve patients underwent recatheterisation (11 at six months and one at one week after balloon dilatation), which showed further improvement with significant reductions in right ventricular pressure or pulmonary valve gradient or both, particularly in the patients with the least satisfactory initial results. This improvement was attributed to resolution of the obstruction at infundibular level. Repeat pulmonary valve dilatation was successfully performed in four patients who had poor results after initial dilatation. Balloon pulmonary valvotomy appears to provide good short term and medium term relief of pulmonary valve stenosis and may obviate the need for surgery in many cases. An apparently poor immediate haemodynamic result does not preclude a good longer term result.

Full text

PDF
435

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Griffith B. P., Hardesty R. L., Siewers R. D., Lerberg D. B., Ferson P. F., Bahnson H. T. Pulmonary valvulotomy alone for pulmonary stenosis: results in children with and without muscular infundibular hypertrophy. J Thorac Cardiovasc Surg. 1982 Apr;83(4):577–583. [PubMed] [Google Scholar]
  2. Kan J. S., White R. I., Jr, Mitchell S. E., Anderson J. H., Gardner T. J. Percutaneous transluminal balloon valvuloplasty for pulmonary valve stenosis. Circulation. 1984 Mar;69(3):554–560. doi: 10.1161/01.cir.69.3.554. [DOI] [PubMed] [Google Scholar]
  3. Kan J. S., White R. I., Jr, Mitchell S. E., Farmlett E. J., Donahoo J. S., Gardner T. J. Treatment of restenosis of coarctation by percutaneous transluminal angioplasty. Circulation. 1983 Nov;68(5):1087–1094. doi: 10.1161/01.cir.68.5.1087. [DOI] [PubMed] [Google Scholar]
  4. Kan J. S., White R. I., Jr, Mitchell S. E., Gardner T. J. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med. 1982 Aug 26;307(9):540–542. doi: 10.1056/NEJM198208263070907. [DOI] [PubMed] [Google Scholar]
  5. Lababidi Z., Wu J. R. Percutaneous balloon pulmonary valvuloplasty. Am J Cardiol. 1983 Sep 1;52(5):560–562. doi: 10.1016/0002-9149(83)90026-7. [DOI] [PubMed] [Google Scholar]
  6. Pepine C. J., Gessner I. H., Feldman R. L. Percutaneous balloon valvuloplasty for pulmonic valve stenosis in the adult. Am J Cardiol. 1982 Dec;50(6):1442–1445. doi: 10.1016/0002-9149(82)90491-x. [DOI] [PubMed] [Google Scholar]
  7. Ring J. C., Kulik T. J., Burke B. A., Lock J. E. Morphologic changes induced by dilation of the pulmonary valve anulus with overlarge balloons in normal newborn lambs. Am J Cardiol. 1985 Jan 1;55(1):210–214. doi: 10.1016/0002-9149(85)90330-3. [DOI] [PubMed] [Google Scholar]
  8. Rocchini A. P., Kveselis D. A., Crowley D., Dick M., Rosenthal A. Percutaneous balloon valvuloplasty for treatment of congenital pulmonary valvular stenosis in children. J Am Coll Cardiol. 1984 Apr;3(4):1005–1012. doi: 10.1016/s0735-1097(84)80360-5. [DOI] [PubMed] [Google Scholar]
  9. Shuck J. W., McCormick D. J., Cohen I. S., Oetgen W. J., Brinker J. A. Percutaneous balloon valvuloplasty of the pulmonary valve: role of right to left shunting through a patent foramen ovale. J Am Coll Cardiol. 1984 Jul;4(1):132–135. doi: 10.1016/s0735-1097(84)80330-7. [DOI] [PubMed] [Google Scholar]
  10. Tynan M., Baker E. J., Rohmer J., Jones O. D., Reidy J. F., Joseph M. C., Ottenkamp J. Percutaneous balloon pulmonary valvuloplasty. Br Heart J. 1985 May;53(5):520–524. doi: 10.1136/hrt.53.5.520. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Tynan M., Jones O., Joseph M. C., Deverall P. B., Yates A. K. Relief of pulmonary valve stenosis in first week of life by percutaneous balloon valvuloplasty. Lancet. 1984 Feb 4;1(8371):273–273. doi: 10.1016/s0140-6736(84)90140-5. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES