INFLUENCE OF BALLOON DIAMETER TO VALVE RING RATIO ON CLINICAL OUTCOMES OF BALLOON VALVULOPLASTY FOR PULMONARY STENOSIS
Abstract
Objective: To analyze the results of balloon valvuloplasty (BV) in patients of different age groups with pulmonary artery stenosis (PAS).
Material and Methods: Clinical data were obtained from 180 patients with PAS and right ventricular obstruction who underwent BV at the State Research Center of Pediatric Hematology, Oncology, and Immunology named after Academician V. Vakhidov between 2010 and 2022. Inclusion criteria: diagnosed isolated pulmonary valve stenosis confirmed by echocardiography. Exclusion criteria: critical valve stenosis, pregnancy, and complex congenital heart defects. Patients were categorized by age, type of PA obstruction, and the ratio of balloon catheter diameter to valve annulus diameter (b/d PA).
Results: In Group 1 (b/d PA < 1, n=15), after BV, the systolic pressure in the right ventricle (RV) decreased from 143.1 ± 10.4 to 85.6 ± 8.7 mmHg, the pressure in the PA increased from 20.5 ± 3.8 to 31.3 ± 3.2 mmHg, and the pressure gradient (PG) decreased from 118.3 ± 8.5 to 54.3 ± 6.1 mmHg. Results were good in 8 (53.3%) patients, satisfactory in 3 (20.0%), and unsatisfactory in 4 (26.7%).
In Group 2 (b/d PA from 1 to 1.2, n=107), the systolic pressure in the RV decreased from 121.1 ± 13.7 to 58.2 ± 6.8 mmHg, the pressure in the PA increased from 23.0 ± 3.1 to 27.8 ± 3.4 mmHg, and the PG decreased from 97.3 ± 10.2 to 30.4 ± 4.6 mmHg. Results were good in 84 (78.5%) patients, satisfactory in 14 (13.1%), and unsatisfactory in 9 (8.4%).
In Group 3 (b/d PA > 1.2, n=58), after BV, the systolic pressure in the RV decreased from 120.0 ± 13.2 to 53.1 ± 6.6 mmHg, the pressure in the PA increased from 22.2 ± 2.4 to 27.9 ± 3.1 mmHg, and the PG decreased from 98.2 ± 10.3 to 25.0 ± 5.1 mmHg. Results were good in 41 (70.7%) patients, satisfactory in 14 (24.1%), and unsatisfactory in 3 (5.2%).
Conclusion: The results of our study indicate that balloon catheters with a diameter-to-pulmonary valve annulus ratio greater than 1.2 provide the best clinical outcomes in balloon valvuloplasty.
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Faisal Talukder, Li Hongxin, Liang Fei, Muhsin Billah Bin Khashru Percutaneous balloon valvuloplasty of pulmonary valve stenosis: state of the art and future prospects //International Surgery Journal, 2020; 7 (2):
