Pulmonary Valve Stenosis and Percutaneous Balloon Pulmonary Valvuloplasty: Are We All Clear About This Disease and Procedure?

Xiaodong Qian
Department of Cardiology
First Affiliated Hospital of Soochow University
Suzhou, People’s Republic of China

Pulmonary valve stenosis (PVS), which causes obstruction of the right ventricular outflow tract, is a relatively common congenital heart disease in children but is relatively rare in adults. The normal pulmonary valve has three cusps, which are completely separated at their junctions. The typical PVS usually has intact but thickened cusps, and the junctions of two cusps are fused. The traditional treatment for PVS is surgical valvotomy. In 1982, the technique of percutaneous balloon pulmonary valvuloplasty (PBPV) was introduced initially by Kan et al. Since then, many authors have reported the successful application of this technique to treat PVS. A large amount of data has shown that PBPV can provide good immediate, mid-term, and long-term results for children with PVS, but data about outcomes (especially long-term) for PBPV treating adult PVS are limited. The decision about the type of treatment should be made according to the degree of hemodynamic changes. Balloons whose diameters exceeded the ring measurement by 20% on angiography were shown to be safe and effective. However, some patients had less-optimal immediate results. Some had spontaneous reduction of peak systolic gradient to normal, and some required a repeat PBPV. Which factors can predict the long-term results of PBPV for adult PVS? What is the mechanism of the spontaneous reduction of of peak systolic gradient? What is the cut-off point of of peak systolic gradient for the indication of PBPV? We still need firm answers to these questions.

To read Dr. Qian’s 41-patient study on the long-term outcomes of PBPV in adult pulmonary valve stenosis patients, please visit:

Percutaneous Pulmonary Balloon Valvuloplasty Provides Good Long-Term Outcomes in Adults With Pulmonary Valve Stenosis, by Xiaodong Qian, MD;  Yunxia Qian, MD;  Yafeng Zhou, MD;  Xiangjun Yang, MD
J INVASIVE CARDIOL 2015;27(12)E291-E296. Epub 2015 August 25

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