Pulmonary Balloon Valvuloplasty for the Treatment of Isolated Pulmonary Valve Stenosis in the Newborn

Pulmonary balloon valvuloplasty (PBV) represents the clıosen procedure for the management of isolated pulmonary valve stenosis (PS) of the newborn. The purpose of this study was to evaluate the immediate and medi u ın-terın results of PBV. Between January 1986 and 1997, 104 newbom underwent PBV for the treatment of PS with intact ventricular septuın. The median weight was 3,2 kg, and median age was 4 days. Twenty-five patients (23%) required prostaglandines Eı perfusion. All patients had a tripartite right ventricle. The tricuspid valve annulus ranged from 9 to 14 mm (ınean ll ± 1,7 ının). PBV was performed as a priınary procedure and was effective in 87 patients (83%). Balloon to pulınonary annulus ratio was measured 1,1 - 1,5 (mean 1,2). Iınmediately after dilatation, the mean transvalvular gradient decreased from 82 ± 24 mmHg to 19 ± 17 mmHg, and right ventricular 1 aortic systolic pressure ratio decreased from 1,3 ± 0,3 to 0,6±0,25. Perforation of the right ventricular outflow tract was the ınajor coınplication for one patient resulting in fatal outcome. Sixteen patients required surgical treatment. Median follow-up was 2,7 years (range 8 months to 9,5 years). Eight patients required repeated BPV for restenosis. At the last visit the mean peak instantaneous Doppler transvalvular gradient was 13±12 mmHg. In conclusion; PBV is effective, safe and represents the chosen procedure for the treatment of isolated pulmonary valvular stenosis in newborn.