| Objectives:Pulmonary stenosis (PS) is one of the most common forms of congenital heart disease. The traditional method of treatment for congenital PS is surgical valvotomy. In recent years, percutaneous balloon pulmonary valvuloplasty (PBPV) has largely replaced surgical valvotomy except in patients with dysplastic valves. The immediate results and the short-and medium-term follow-up of PBPV have already been well documented in the literature. However, reports on long-term follow-up are still limited. The purpose of this study is to report the immediate-and long-term results of PBPV in our institution, and to analyze the factors that influence the effects of the procedure.Methods:This study comprised 243 patients (111 males) with PS undergoing PBPV from June 2002 to October 2009, whose age ranged from 2 months to 77 years. The criterium for indicating PBPV was isolated congenital PS with a peak-to-peak pulmonary transvalvular systolic gradient obtained during the therapeutic greater than 40 mmHg, and patients with other heart diseases and other system diseases were excluded from the study. The procedure was classified as "excellent" when the PTG was reduced to levels<25 mmHg, "good" when the PTG was reduced to levels 25-50 mmHg, and "poor" when the PTG>50 mmHg after procedure. The relevance of post-procedure PTG and factors including age, balloon/annulus diameter ratio, and pre-procedure PTG was determined by multiple regression analysis. Every patient who underwent successful PBPV was followed up clinically and by ECG and echocardiogram at 1,3,6 months during the first year. Results:Of the 243 patients,85 (35.0%) were symptomatic and all of them had a systolic murmur at pulmonary valve region. Electrocardiogram showed right ventricular hypertrophy in 189 patients (77.8%) and incomplete right bundle branch block in 28 (11.6%).98.9% of patients underwent successful valvuloplasty whose PTG decreased from 76.05±39.23 mmHg to 18.29±19.66 mmHg (P<0.01). The outcome of PBPV was excellent in all the patients with mild PS with PTG decreased from 26.23±4.84 mmHg to 8.12±4.87 mmHg (P<0.01), excellent in 145 (89.0%), and good in 17 (10.4%) in patients with moderate stenosis with PTG decreased from 60.60±19.84 mmHg to 14.55±9.39 mmHg (P<0.01), and excellent in 49 (69.8%) and good in 11 (17.5%) in patients with severe stenosis with PTG decreased from 129.48±27.67 mmHg to 32.51±30.58 mmHg. Procedural complications included conculsion of right ventricular outflow tract in 7 (0.03%) and pulmonic regurgitation in 37 (15.2%). The patients were followed up for 3.53±2.03 Years. Normal electrocardiograms were observed in 164 (86.7%) patients, and right axis deviation or incomplete right bundle branch was observed in 19 (10.1%) in patients who had right ventricular hypertrophy before PBPV. Echocardiograms showed PTG of 76.05±39.23 mmHg before PBPV,21.30±6.74 mmHg at 1 month, 18.30±5.64 mmHg at 3 months, and 14.48±5.26 mmHg at 6 months after procedure. Multiple regression models showed that pre-procedure PTG and balloon/annulus diameter ratio were positively associated with post-procedure PTG, while the patient's age were not associated with it.Conclusions:Percutaneous balloon valvuloplasty was effective and safe for the treatment of pulmonary valve stenosis with excellent short-and long-term results. Pre-procedure PTG and balloon/annulus diameter ratio were positively associated with post-procedure PTG, but the patient's age has no positive influence on the effect of percutaneous balloon valvul-oplasty.
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