Objectives: To evaluate the efficacy and safety of balloon pulmonary valvuloplasty (BPV) in children. Design, setting and method: This is a retrospective review of 101 consecutive patients with pulmonary stenosis who underwent BPV at the Lady Ridgeway Hospital for Children over a period of 42 months. Four patients were excluded as they had complex cardiac problems. Data was obtained from Excel based cardiac catheterization reports in the Department of Paediatric Cardiology. Reduction of pressure gradient across pulmonary valve to less than 25 mmHg was defined as a successful procedure. Results: Ninety seven BPVs were performed in 94 patients. The mean age, bodyweight and height were 19 months, 9.5 kg and 80 cm respectively. Sex distribution was equal. The mean of the balloon to pulmonary annular ratio was 108% (range 50-150%). After the BPV, mean peak to peak pressure gradient across the pulmonary valve dropped from 70±29 mmHg to 24.7±16.8 mmHg. Overall success rate was 55.7%. Mortality was 3.1%. Major complications were haemopericardium (4.1%), bradycardia (2%) endocardial damage (1%) and pulmonary oedema (1%). The correlation between pulmonary annulus on echocardiography and angiography was significant (p<0.01).
Congenital heart disease has an incidence of 8 per 1000 live births 1 and contributes significantly to childhood morbidity and mortality. Therefore, basic understanding on pathophysiology of different lesions and management options is vital for a practicing paediatrician.
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