Clinical Profile and Outcome of Percutaneus Transcatheter Balloon Pulmonary Valvuloplasty in Indonesia

  • Ms Shirley Anggriawan, Cipto Mangunkusumo Hospital, Jakarta- Indonesia, Indonesia
  • Mr Rahmat Kuswiyanto, Division of Cardiology, Department of Child Health, Medical School, University of Indonesia / Integrated Cardiovascular Service, Indonesia
  • Mr Mulyadi Djer, Division of Cardiology, Department of Child Health, Medical School, University of Indonesia / Integrated Cardiovascular Service, Indonesia
  • Mr Sukman Putra, Division of Cardiology, Department of Child Health, Medical School, University of Indonesia / Integrated Cardiovascular Service, Indonesia

    • Background: Pulmonary valvuloplasty is currently the first line of treatment for pulmonary valve stenosis at any ages. With pure valve stenosis, one should expect to reduce the pressure gradient (PG) across the nondysplastic pulmonary valves to < 10 mmHg by using balloon valvuloplasty.

    Objective: The aim of this study was to describe the clinical profile and outcome of Percutaneus Trancatheter Balloon Pulmonary Valvuloplasty (PTBV) in children with severe PS.

    Method: This research is a case study, which involved 33 patients with severe nondysplastic valvular PS since 2002 – 2008. PA and RV pressure were obtained before and after ballooning.

    Results: PTBV were performed for 33 patients (20 males, 13 females), median age and weight were 18 (range: 3-160) month and 8.9 (range 4.8-38) kg. Balloon diameters were 1.3 times the size of the pulmonary valve annulus (median size of annulus was 12 mm, size of device was 16). PTBV significantly reduced PG across the pulmonary valve with mean pulmonary PG before PTBV was 57 mmHg, median PG after PTBV was 16 mmHg, respectively (p<0.0001). The corresponding median values for RV systolic pressure were 82 mmHg and 43 mmHg, respectively. Inflation of the balloons in pulmonary valve results in bradycardia in 3 cases and return rapidly with a successful dilation.

    Conclusion: PTBV were successfully done in 33 cases, with good immediate results. Long-term follow-ups are needed. Ballon pulmonary valvuloplasty has supplanted surgical valvotomy as the procedure of choice for this lesion in our institution.

    Keyword: Pulmonary valve stenosis, ballon pulmonary valvuloplasty