Evaluation of independent determinants in successful pulmonary balloon valvuloplasty

Aim: The aim of this study was to evaluate the echocardiagraphic an the angiographic findings of pulmonary balloon valvuloplasty before and after the procedure and to determine independent predictors leading to success of valvuloplasty for pediatric patients with valvular pulmonary stenosis. Materials and Methods: From January 2010 - Agust 2014, 48 pediatric patients with moderate to severe valvular pulmonary stenosis, who is undergoing percutaneous balloon valvuloplasty, were enrolled in this retrospective study. The gradient was measured pre and immediately, postvalvuloplasty at catheterization, and by echocardiography at follow up. Results: 48 patients who had undertaken balloon pulmonary valvuloplasty were included in this study. 45,8% were female, 54,2% were male. There were isolated valvular type pulmonary stenosis in 39 patients, valvular and indindubular type pulmonary stenosis in 3 patients, valvular and supravalvular type pulmonary stenosis in 5 patients. The mean peak to peak pressure gradient across pulmonary valve before and immediately after pulmonary balloon valvuloplasty was 72,3 ± 26,8 mmHg and 26,8 ± 19,8 mmHg (P<0.05) respectively. Doppler pressure gradient across pulmonary valve before pulmonary balloon valvuloplasty and a day after were 73,6 ± 22,1 mmHg and 34,3 ± 19,2 mmHg (P<0.05). Pulmonary balloon valvuloplasty was successful and partially succesful in 41 of 48 patients (85,4 %). The procedure was unsuccessful in 7 patients (14,6 %). Therefore, it can be considered as treatment of choice for patients with typical valvular pulmonary stenosis. A smaller length of balloon significantly predicted unsuccessful outcomes of balloon pulmonary valvuloplasty. Patient age, weight, diameter balloon, diameter of valve, ratio of balloon to valve diameter, pre-balloon valvuloplasty hemodynamic parameters, did not independently predict follow-up outcomes. Conclusion: Independent determinants; such as; age, weight, sex, diameter of ballon and pulmonary annulus and ratio of diameters of pulmonary annulus to balloon, have no role in the success of valvuloplasty. The lenght and the degree of pulmonary stenosis determine the success of valvuloplasty. Key Words: Pulmonary stenosis, pulmonary balloon valvuloplasty, childhood.