Biochemistry

   

Long-Term Follow-Up Analysis of Percutaneous Balloon Pulmonary Valvuloplasty: Experience of an Indian Tertiary Care Hospital

Authors: Babu Ezhumalai, Neeraj Awasthy, Ajit Ananthakrishna, Santhosh Satheesh, Balachander Jayaraman

Objectives: Our objectives were to study the effectiveness and long-term follow-up outcomes of percutaneous Balloon Pulmonary Valvuloplasty (BPV) performed in adults and children at an Indian tertiary care hospital. Methods: This retrospective study included patients with more than mild congenital valvular Pulmonary Stenosis (PS) having echocardiographic peak gradient ≥50mmHg, who underwent BPV in a tertiary care hospital in India from 1988 to 2011. Clinical profile, echocardiographic details, procedural data, complications etc were studied. Patients were followed with annual echocardiographic and clinical assessment. Results: 108 patients including 37 children and 71 adults underwent BPV. Single balloon technique was mostly employed (99.1%). The mean balloon/annulus ratio was 1.22 ± 0.02. The transvalvular peak-to-peak gradient measured immediately before and after valvuloplasty was 103.4 ± 33.9mmHg and 33.9 ± 17.5mmHg respectively (65.1% reduction, p<0.0001). Intervention was successful and partially successful in 100 (92.6%) subjects and 8 (7.4%) subjects respectively, irrespective of age and gender. Less than moderate pulmonary regurgitation occurred in 73 (67.6%) patients. At discharge, peak Doppler gradient was reduced by 74.1% compared to admission value. This was further significantly reduced (25.4%) at short-term follow-up. This reduction in gradient was sustained at mid-term and long-term follow-up. The median duration of follow-up was 15years (range: 2 to 27 years). All patients were asymptomatic at short-term and mid-term follow-up. Two (1.9%) patients who developed restenosis on long-term underwent repeat valvuloplasty. Conclusions: BPV is a well-tolerated non-surgical treatment modality for congenital valvular PS producing highly effective results irrespective of age or gender. The results are excellent at immediate-term, short-term, mid-term and long-term. Submit Your Manu Script at: https://symbiosisonlinepublishing.com/submitManuscript.php

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[v1] 2017-08-24 01:42:01

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