Factors determining immediate and medium-term results after pulmonary balloon valvuloplasty

Silvilairat, S.; Pongprot, Y.; Sittiwangkul, R.; Phornphutkul, C.

Journal of the Medical Association of Thailand 89(9): 1404-1411

2006


ISSN/ISBN: 0125-2208
PMID: 17100377
Document Number: 2635
Objective: To determine factors influencing immediate and medium-term results of Pulmonary Balloon Valvuloplasty (PBV) for pulmonary valve stenosis.Material and Method. Between 1995 and 2001, the authors carried out PBV in 25 consecutive patients. Two treatment outcomes including immediate and medium-term results were analyzed The immediate results were classified into two groups based on the pulmonary systolic pressure gradient (PG) immediately after dilation: group I with a PG <= 35 mmHg andgroup H with a PG > 35 mmHg. At medium-term follow-up of 6 to 60 months, echocardiographic evaluations were analyzed and divided into two groups: group A with a PG <= 25 mmHg andgroup B with a PG > 25 mmHg. Demographic characteristics and hemodynamic parameters of immediate and medium-term results were compared and analyzedResults: Immediately after PBV the right ventricular systolic pressure (RVSP) decreased from 115.3 +/- 37.6 mmHg to 67.0 +/- 28.5 mmHg (p < 0.001). The pulmonary systolic pressure gradient decreased from 90.4 +/- 37.9 mmHg to 39.3 +/- 25.6 mmHg (p < 0.001). Nine of the 25 patients (group II; 36%), with incomplete immediate relief of the obstruction, had more symptoms, a higher baseline PG higher right atrial pressure, higher RVSP, and a higher systolic pressure ratio. Six of the 25 patients (group B; 24%), with suboptimal medium-term results, had a higher right ventricular voltage on the electrocardiogram, higher pre-dilation PG and higher RVSP.Conclusion: Successful medium-term outcomes following pulmonary balloon valvuloplasty were achieved in 76% of the patients, with a greater success rate (91%) in patients with a lower right ventricular voltage electrocardiogram (R wave amplitude in V) <= 21 mm, a prevalvuloplasty systolic gradient <= 90 mmHg, and right ventricular systolic pressure < 125 mmHg.

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Factors determining immediate and medium-term results after pulmonary balloon valvuloplasty