Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

Idrizi, Shpend; Milev, Ivan; Zafirovska, Planinka; Tosheski, Goce; Zimbakov, Zan; Ampova-Sokolov, Vilma; Angjuseva, Tanja; Mitrev, Zan

doi:10.3889/oamjms.2015.089

Cited by 12 publications

(11 citation statements)

References 28 publications

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“…A study from Iran 21 showed 57 % of patients had mild pulmonary regurgitation in the immediate post BPV period. Similarly, mild PR was noted in 55% of patients in Idrizi S et al study 22 while 34% patients developed mild PR in Qian X et al study. 14 The incidence of mild pulmonary valve regurgitation in immediate post BPV period was 48.8% in our study while there was not a single case of moderate or severe regurgitation.…”

Section: Discussionmentioning

confidence: 76%

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

2020

APMC

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Background: Balloon pulmonary valvuloplasty is the procedure of choice for pulmonary valve stenosis in any age group. The data on efficacy of the procedure in adolescent and adult population is scanty in Pakistan. Objective: To determine the early outcome of balloon pulmonary valvuloplasty in adolescents and adults. Study Design: Descriptive retrospective case series. Settings: Pediatric cardiology department of Faisalabad Institute of Cardiology, Faisalabad-Pakistan. Duration: Three years and Six months from 01-01-2016 to 30-06-2019. Methodology: All consecutive patients of age 10 years or above who underwent percutaneous balloon pulmonary valvuloplasty in the study period were enrolled. The outcome parameters including successfulness and complications of procedure recorded. The procedure was labelled successful if peak to peak pressure gradient across pulmonary valve reduced to less than 50% or more of the pre procedure value, suboptimal if gradient reduced by 25-49% and unsuccessful if gradient reduced by less than 25%. Results: A total of 41 patients underwent balloon pulmonary valvuloplasty procedure. Mean age was 22.2± 10.5 years while female to male ratio was 1.05:1. Majority of the patients (n=26, 63.4%) were symptomatic and dyspnea on exertion was the dominant symptom (n=16, 39%). Majority of the patients had doming pulmonary valve (n=37, 90.2%). Mean balloon to pulmonary valve annulus ratio was 1.24 ± 0.1 (range 1.1-1.43). The procedure was successful in all patients (n=41, 100%) as the mean peak to peak pressure gradient across pulmonary valve decreased from 121.9 ± 53.2 mmHg (pre valvuloplasty) to 30.1±11.9 mmHg (post valvuloplasty) irrespective of doming or dysplastic valve. There were no major complications. Transient self-limiting vaso-vagal syncope was noted in 7.3% of patients (n=3). On post procedure echocardiography there was not a single case of moderate or severe pulmonary valve regurgitation (PR) while mild PR was observed in 48.8% patients (n=20). Conclusion: Balloon pulmonary valvuloplasty in adolescent and adult patients is a very safe procedure with high success but very low complications rate.

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Section: Discussionmentioning

confidence: 76%

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

2020

APMC

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“…PS may also be associated with a combination of infundibular hypertrophy and post stenotic dilation. These are frequently seen in older patients with longstanding PS and those with higher degree of valvular stenosis [11]. Post stenotic dilation and infundibular hypertrophy are more frequently seen in the nonreduced RVSP group or group 2 (47.2% and 62.9% respectively) but p value was not significant because of small sample size.…”

Section: Discussionmentioning

confidence: 82%

The results of Percutaneous Transcatheter Pulmonary valvuloplasty in Adult Patients

Hosseini

2021

JOCCT

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Background: Pulmonary valve stenosis (PS) is a rare congenital heart disease in adults. Commissural fusion and narrowing of the central lumen are the basic pathology in valvular PS.Methods: This trial is a retrospective observational cohort study which is performed from 2011 to 2020 in 107 adult patients with congenital pulmonary valve stenosis, who were referred to Rajaie Cardiovascular Medical and Research Center, the largest referral center for congenital heart disease in adults in Iran. Procedural technique, immediate and up to one year follow-up of these patients, and the definition of successful intervention are described.Results: A total of 107 patients underwent percutaneous transcatheter pulmonary commissurotomy (PTPC). The mean age was 33.1 ± 12.8 years (18-79 years), of whom 46 (43%) were male. More than half of the patients (62.6%) had NYHA functional class ≥II before the intervention. The peak gradient of pulmonary valve (PVPG) decreased from 91 ± 34.7mmHg at baseline to 38.9 ± 16.1mmHg immediately post valvuloplasty (p = 0.032). The right ventricular systolic pressure (RVSP) decreased from 115.9 ± 34.1mmHg at baseline to 59.2 ± 20.1mmHg post procedure (p <0.001). Successful PTPC, based on transvalvular gradient (≤25 mmHg), was confirmed in 90 (85%) patients whereas when based on RVSP reduction>50%, the percentage of success rate was reduced to 42 (40%) of patients. The success rate after one year follow-up was 92.5%. After one year follow-up only 8 (7.5%) patients did not respond to PTPC (PVPG>25mmHg), of whom, about 4.5% had dysplastic valves and 3% had severe infundibular hypertrophy respectively. Also, in subgroup analysis we compared patients in two groups based on the RVSP reduction and transvalvular gradient. Conclusion:The PTPC is a safe and efficient procedure in adult patients with severe pulmonary valve stenosis. Irrespective of sub-valvular gradient, in majority of cases, the gradient would be decreased significantly during one-year follow-up after PTPC (92.5% in this study). The use of beta blockers in patients with infundibular hypertrophy could reduce the gradient dramatically; in such a way that after 1 year the degree of residual gradient is minimal; so, we demonstrated that if the successful criteria in adult patients after PTPC being just only on the RVSP reduction>50%, it would lead to underestimation of effectiveness of PTPC; so, we suggest that the best criteria of successful PTPC in adult patients is post procedure peak systolic valvular gradient<25mmHg.

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“…Розподіл пацієнтів в залежності від післяопераційних ускладнень наведено в таблиці 3. Таким чином наші дані співпадають з даними інших авторів [9]. У післяопераційному періоді помер 1 (1%) пацієнт внаслідок прогресуючої серцевої недостатності.…”

Section: Plys2005@ukrnetunclassified

Endovascular Methods of Treatment Pulmonary Artery Stenosis

Imanov¹,

Truba²,

Pliska³

et al. 2020

Ukr. ž. med. bìol. sportu

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Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience

Cited by 12 publications

References 28 publications

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

The results of Percutaneous Transcatheter Pulmonary valvuloplasty in Adult Patients

Endovascular Methods of Treatment Pulmonary Artery Stenosis

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