Outcomes of percutaneous balloon pulmonary valvuloplasty in pulmonary valve stenosis in the pediatric population at the Instituto Nacional Cardiovascular-INCOR, Lima – Peru

Huamán-Benancio G.; Peralta-Ponce C.; Vinelli-Arzubiaga D.; Esquivel-León C.; Pinedo-Torres I. · Archivos Peruanos de Cardiologia y Cirugia Cardiovascular (2022) · DOI: 10.47487/apcyccv.v3i2.208

Resumen

Objective. To evaluate the effectiveness of the procedure and outcomes during follow-up. Methods. 80 patients with pulmonary valvular stenosis who underwent percutaneous balloon valvuloplasty between January 2014 and December 2019 were described. Demographic, echocardiographic, and hemodynamic characteristics of the procedure were evaluated. Follow-up included clinical, echocardiographic parameters, pulmonary regurgitation severity, and residual pulmonary gradient at each cutoff point. Results. The age range was 2 years (interquartile range: 10.5-72 months), and the predominant sex was male with 56.2%. The transvalvular pulmonary gradient decreased from 61.7 mmHg ±21.2 to 17 mmHg (interquartile range: 11-26 mmHg)]. The immediate success rate was 90%. Follow-up time showed a median of 21 months (interquartile range: 5-47.5 months). All patients at follow-up showed some degree of pulmonary insufficiency at each cutoff point; 17% of the cases at the end of their follow-up were found to have severe insufficiency. Three cases of long-term restenosis were found (3.8%), and 6 (7.5%) were admitted for valvuloplasty surgery or pulmonary valve replacement. The complications reported reached 10% of cases, two patients were admitted to surgery during the procedure for major complications. A significant association was found with severe pulmonary insufficiency at the end of follow-up and ring/balloon ratio. Conclusions. Percutaneous transluminal valvuloplasty with balloon is an effective technique in the treatment of pulmonary valvular stenosis, with reported complications but with good results during follow-up.

Instituciones: Universidad Ricardo Palma