Follow-up Results of Percutaneous Pulmonic Balloon Valvuloplasty in Adult with Pulmonic Stenosis
Abstract
- Percutaneous pulmonic balloon valvuloplasty(PPV) was performed in 23 patients with moderate to severe degree of pulmonary stenosis(PS) from March, 1986 to May, 1991. The patients were 26.4 years old, range from 15-44, and 13 of them were males. 19 patients of them had valvular stenosis and the other 4 patients had combined combined stenosis with infundibular stenosis. Associated cardiac defects were atrial septal defect(ASD) in 3 patient, patient foramen ovale(PFO) in two patients, and patent ductus arteriosus(PDA) in one patient. Transpulmonic peak systolic pressure gradient(big up tri, openP) decreased from 88.6+/-34.2mmHg to 31.2+/-21.3mmHg after PPV(p<0.01). The right ventricular peak systolic pressure(RVSP) decreased from 105.8+/-35.3mmHg to 47.1+/-20.3mmHg(p<0.01). after PPV. In 7 patients, follow-up(F/U) cardiac catheterization and right ventricular angiography was performed 13 months later(6mon-29mo). big up tri, openP at pre PPV, at immediate post PPV and at long-term F/U were 90.3+/-44.3mmHg, 29.6+/-23.4mmHg and 21.9+/-11.9mmHg, respectively. There was significant decrease in big up tri, openP between pre PPV and immediate post PPV(p<0.01), but no significant change between the immediate post PPV and long-term F/U. The RVSP at pre PPV, at immediate post PPV and at long-term F/U were 109.6+/-45.4mmHg, 48.1+/-23.0mmHg and 43.3+/-13.1mmHg, respectively. There was significant ddecrease in RVSP between pre PPV and immediate post PPV(p<0.01), and no significant decrease in RVSP between immediate post PPV and long-term F/U(p>0.05). The sum of amplitudy of R wave in V1 and that of S wave in V6 in ECG(R1+S6) represents the degree of rigth ventricular hypertrophy. The ECG was followed-up for 15.3months(6~29months) in 11 patients and R1+S6 at pre PPV and at follow-up were 15.9+/-9.1mm and 9.3+/-4.1mm(p<0.01). In summary PPV can achieve very good short-term and long-term results in relieving moderate to severe pulmonic stenosis in adult.