Retrospective Analysis Of Immediate Therapeutic Outcomes And Long-term Follow-up Effects Of Percutaneous Balloon Pulmonary Valvuloplasty In Congenital Pulmonary Valve Stenosis In The Pediatric Population

Objective: To analyze the immediate and long-term follow-up effects of percutaneous balloon pulmonary valvuloplasty(PBPV)in the treatment of congenital pulmonary valve stenosis(PVS)in children.Methods: The study consisted of 228 children with PVS who underwent PBPV from January 2004 to October 2019 at a single center.The risk factors for ≥moderate pulmonary regurgitation(PR),residual stenosis,and re-stenosis were analyzed based on the baseline patient characteristics and measured value of corresponding inspection results.Results: Among 228 patients,follow-up results were obtained in 193 patients.In the 193 patients with follow-up data,the mean follow‐up duration was 18.58 months,(median 8 months;interquartile range [IQR]:3.5–8 months).Immediately after PBPV,the Right ventricular to Pulmonary artery(RV-PA)peak systolic ejection gradient(PSEG)reduced significantly from 54.84 mm Hg(median: 49 mm Hg,IQR: 33–67 mm Hg)to 19.50 mm Hg(median: 14 mm Hg,IQR: 9–23 mm Hg).The immediate success rate was 89.6%.Seventy‐six patients(39.4%)had ≥moderate PR,32(16.6%)had residual PS ≥40 mm Hg or re-stenosis,and 9(4.7%)had re‐intervention.The univariate analysis demonstrated that young age,low weight,small pulmonary annulus diameter,higherinitial RV-PA PSEG,increased RV/systemic pressure ratio,and severe PVS were associated with≥moderate PR.Small pulmonary annulus diameter,higher initial RV-PA PSEG,increased RV/systemic pressure ratio,and severe PVS were associated with residual stenosis and re-stenosis.The multivariate analysis demonstrated that higher initial RV-PA PSEG and low weight were independently associated with ≥moderate PR,while higher initial RV-PA PSEG was independently associated with residual stenosis and re-stenosis.Conclusion:PBPV is a preferred treatment in PVS children with higher success rate.Higher initial RV-PA PSEG was a significantfactor for≥moderate PR,residual stenosis,and re-stenosis.