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The effect of balloon valvuloplasty for bioprosthetic valve stenosis at pulmonary positions

Eun Young Choi1, Jinyoung Song2, Heirim Lee2, Chang Ha Lee3, Jun Huh2, I.-Seok Kang2, Ji Hyuk Yang4, Tae Gook Jun4
1 Department of Pediatrics, Sejong General Hospital, Bucheon, Korea
2 Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3 Department of Thoracic Surgery, Sejong General Hospital, Bucheon, Korea
4 Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
* Corresponding Author: Jinyoung Song, Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Email:

Congenital Heart Disease 2017, 12(6), 746-750. https://doi.org/10.1111/chd.12507

Abstract

Background: Balloon dilatation of a bioprosthetic valve in the pulmonary position could be performed to delay valve replacement. We proposed to identify the long-term effectiveness of such a procedure.
Methods: We reviewed the medical records of 49 patients who underwent balloon valvuloplasty between January 2000 and December 2015. The primary goal was to determine the time interval until the following surgical or catheter intervention.
Results: The mean age at bioprosthetic valve insertion was 5.7 years old, and the mean age for ballooning was 11.7 years. The mean interval after pulmonary valve replacement was 71.6 months. The mean ratio of balloon size to valve size was 0.94. The pressure gradient through the pulmonary valve after balloon valvuloplasty was significantly improved (55.3 ± 18.5 mm Hg vs 33.8 ± 21.5 mm Hg, P < .001). There were no significant changes in pulmonary regurgitation and no serious adverse events. Patients had a mean freedom from re-intervention of 30.6 months after balloon valvuloplasty. The interval of freedom from re-intervention was affected only by the pressure gradient before balloon valvuloplasty and the patient age at insertion. The mean interval to re-intervention in patients with pressure gradients less than 48.5 mm Hg before ballooning was 46.0 months, which was significantly longer than for those with a higher gradient (18.7 months).
Conclusion: The effectiveness of this process may depend on the pressure gradient before ballooning and the patient age at valve insertion. It is possible that earlier valvuloplasty at pressure gradient not over 48.5mm Hg may have a benefit to delaying re-operation.

Keywords

balloon valvuloplasty, bioprosthesis, pulmonary valve stenosis, re-intervention

Cite This Article

Choi, E. Y., Song, J., Lee, H., Lee, C. H., Huh, J. et al. (2017). The effect of balloon valvuloplasty for bioprosthetic valve stenosis at pulmonary positions. Congenital Heart Disease, 12(6), 746–750.



This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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