Long-Term Outcomes of Balloon Valvuloplasty for Isolated Pulmonary Valve Stenosis

Rajiv Devanagondi; Dan Peck; Janaki Sagi; Janet Donohue; Sunkyung Yu; Sara K Pasquali; Aimee K Armstrong

doi:10.1007/s00246-016-1506-4

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Long-Term Outcomes of Balloon Valvuloplasty for Isolated Pulmonary Valve Stenosis

Journal article

Peer reviewed

Long-Term Outcomes of Balloon Valvuloplasty for Isolated Pulmonary Valve Stenosis

Rajiv Devanagondi, Dan Peck, Janaki Sagi, Janet Donohue, Sunkyung Yu, Sara K Pasquali and Aimee K Armstrong

Pediatric cardiology, Vol.38(2), pp.247-254

02/01/2017

DOI: 10.1007/s00246-016-1506-4

PMID: 27826708

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Abstract

To evaluate the long-term cumulative incidence of ≥ moderate pulmonary regurgitation (PR) and re-intervention following balloon pulmonary valvuloplasty (BPV). While BPV for pulmonary valve stenosis (PS) relieves obstruction acutely, long-term outcomes are not well documented. Between 1982 and 2002, 211 patients had BPV for isolated PS. Follow-up data were available for 103 patients. Cumulative incidence of ≥ moderate PR and re-intervention was evaluated and risk factors for ≥ moderate PR assessed in univariate and multivariable analyses. Median age at BPV was 0.7 years (range 1 day-42.2 years); peak catheter gradient was 65 mmHg (range 31-169 mmHg); 23% had critical PS. Sixty-two patients had a recent echocardiogram with median follow-up 15.1 years (range 10.1-26.3 years); 60% had ≥ moderate PR. Three patients had pulmonary valve replacement following BPV due to symptomatic severe PR. In univariate analysis, critical PS, younger age, smaller BSA, and smaller pulmonary annulus at the time of BPV, as well as greater baseline PS gradient by catheterization, were associated with ≥ moderate PR (all p < 0.05). In multivariable analysis, only BSA < 0.3 m was independently associated with ≥ moderate PR (adjusted odds ratio 6.4, 95% confidence interval 1.2-33.6). In the largest study to date of > 10-year outcomes following BPV, 60% of patients with available follow-up data developed ≥ moderate PR. Few patients had pulmonary valve replacement. Patients with lower BSA at the time of BPV were more likely to have greater PR at late follow-up.

Balloon Valvuloplasty - adverse effects

Catheterization - adverse effects

Child, Preschool

Echocardiography

Female

Follow-Up Studies

Humans

Infant

Infant, Newborn

Kaplan-Meier Estimate

Logistic Models

Male

Michigan

Multivariate Analysis

Pulmonary Valve - physiopathology

Pulmonary Valve Insufficiency - etiology

Pulmonary Valve Stenosis - complications

Pulmonary Valve Stenosis - surgery

Risk Factors

Severity of Illness Index

Time Factors

Treatment Outcome

Details

Title: Subtitle: Long-Term Outcomes of Balloon Valvuloplasty for Isolated Pulmonary Valve Stenosis
Creators: Rajiv Devanagondi - University of Rochester Medical Center
Dan Peck - Mattel Children's Hospital
Janaki Sagi - C. S. Mott Children's Hospital
Janet Donohue - C. S. Mott Children's Hospital
Sunkyung Yu - C. S. Mott Children's Hospital
Sara K Pasquali - C. S. Mott Children's Hospital
Aimee K Armstrong - Nationwide Children's Hospital
Resource Type: Journal article
Publication Details: Pediatric cardiology, Vol.38(2), pp.247-254
DOI: 10.1007/s00246-016-1506-4
PMID: 27826708
ISSN: 0172-0643
eISSN: 1432-1971
Language: English
Date published: 02/01/2017
Academic Unit: Cardiology; Stead Family Department of Pediatrics
Record Identifier: 9984772261602771

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