Efficacy of balloon valvuloplasty in treating mild pulmonary stenosis
Wang, J.K.; Lue, H.C.; Wu, M.H.; Young, M.L.
Acta Cardiologica 47(4): 349-355
1992
ISSN/ISBN: 0001-5385 PMID: 1523915 Document Number: 390562
Balloon pulmonary valvuloplasty (BPV) is a well accepted treatment for moderate and severe pulmonary stenosis. However, the efficiacy of BPV in treating mild pulmonary stenosis is still unanswered. Therefore, the efficacy of BPV in treating patients with mild pulmonary stenosis was compared to that in treating patients with moderate or severe pulmonary stenosis. A total of 46 patients with pulmonary stenosis were arbitrarily divided into 3 groups; Group I consisted of 9 patients with a pressure gradient less than 40 mm Hg, Group II consisted of 5 patients with a pressure gradient ranged from 40 to 50 Hg, and Group III consisted of 32 patients with a gradient greater than 50 mm Hg. Following BPV, the gradient reduced significantly in all 3 groups (p < 0.05 in each group). The efficacy of BPV in the 3 groups was evaluated and compared by two parameters; one is the percentage of gradient reduction, the other is the right ventricular pressure ration (RB post-bpv/RV pre-bpv). The percentage of gradient reduction in Group I, II, and III were 28 .+-. 20, 55 .+-. 17 and 70 .+-. 9% respectively. The right ventricular pressure remained 84 .+-. 11, 59 .+-. 16, and 46 .+-. 12% of pre-valvuloplasty level in Group I, II and III respectively. If the efficacy of BPV was compared among the 3 groups, Groups III had the best efficacy and Group I had the worst. Because the natural course of mild pulmonary stenosis is relatively benign, and the benefit from BPV is rather small, BPV is best reserved for patients with a gradient above 50 mm Hg or patients with symptoms. However for patients with a gradient ranged between 40-50 mm Hg, BPV could also be performed on an elective basis.