Balloon Pulmonary Valvuloplasty in Adults with Congenital Valvular Pulmonary Stenosis

Background: Balloon valvuloplasty has been used for congenital valvular pulmonary stenosis (PS) in pediatric patients as a conventional treatment. The purpose of this study was to further investigate the safety, immediate and long-term results of balloon valvuloplasty in adults with congenital valvular pulmonary stenosis. Method and Result: We analyzed hemodynamic data of 12 patients who underwent balloon pulmonary valvuloplasty (ages 20-80, mean 41 years). Double-balloon technique was used in 8 patients and single-balloon technique in 4 patients (including 1 case with Inoue balloon). Right ventricle systolic pressure and pulmonary valve peak-to-peak systolic pressure gradient decreased from 101.4 35.0 to 48.8 17.7 mmHg (p < 0.001) and 85.3 37.3 to 29.9 20.0 mmHg (p < 0.001), respectively. Ten patients underwent transthoracic Doppler echocardiography follow-up 2-184 months (mean 68.6 months) after pulmonary balloon valvuloplasty, and peak transvalvular systolic pressure gradient further decreased to 15.1 11.9 mmHg (p = 0.001). All patients had symptomatic improvement, and no major complication or mortality was noted. Conclusion: Balloon pulmonary valvuloplasty is a safe and effective treatment for adult patients with congenital valvular PS. In our experience, even elderly patients (up to 80 years old) had satisfactory result.