@Article{chd.12788,
AUTHOR = {Rachel L. Hansen, Iman Naimi, Hongyue Wang, Nader Atallah, Frank Smith, Craig Byrum, Daniel Kveselis, Glenn Leonard, Rajiv Devanagondi, Matthew Egan},
TITLE = {Long‐term outcomes up to 25 years following balloon pulmonary valvuloplasty: A multicenter study},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {6},
PAGES = {1037--1045},
URL = {http://www.techscience.com/schd/v14n6/38896},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> Evaluate long‐term outcomes following balloon pulmonary valvuloplasty
(BPV) for pulmonary stenosis (PS).<br/>
<b>Background:</b> Long‐term data following BPV is limited to small, single center studies.<br/>
<b>Methods:</b> BPV from April 12, 1985 to January 7, 2015 from three centers were
included. Outcomes studied were ≥ moderate PI by echocardiogram and residual
PS ≥ 40 mm Hg. Risk factors for ≥ moderate PI, residual PS, and repeat intervention
were assessed by univariate and multivariate analysis.<br/>
<b>Results:</b> Among 254 patients, mean age at BPV was 3.8 years (range 1 day‐67
years), initial PS catheter gradient was 56 mm Hg (IQR 40‐70), 19% had critical
PS, and 9% had genetic syndromes. Mean follow‐up duration was 7.5 years (maxi‐
mum 25 years). Sixty‐nine (29%) had ≥ moderate PI, 41 patients (17%) had residual
PS > 40 mm Hg, and 31 (13%) had re‐intervention. In univariate analysis, younger
age, lower weight, greater initial PS gradient, greater initial RV/systemic pressure
ratio, critical PS, and longer follow‐up duration were associated with ≥ moderate
PI. Greater initial PS gradient was associated with long‐term residual PS or repeat
intervention. In multivariate analysis, greater initial gradient and lower weight were
independently associated with > moderate PI and greater initial PS gradient and
genetic abnormality were independently associated with residual PS and repeat
intervention.<br/>
<b>Conclusion:</b> Smaller patients with greater initial PS were more likely to develop sig‐
nificant long‐term PI. Patients with greater initial PS and genetic abnormalities were
more likely to have residual PS or require repeat intervention following BPV.},
DOI = {10.1111/chd.12788}
}