Application of percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance

Abstract

Objective To assess the efficacy and safety of percutaneous balloon pulmonary valvuloplasty solely under echocardiographic guidance. Methods From February 2013 to May 2014, 20 patients of congenital pulmonary valve stenosis were recruited. Their mean age was (7.9±3.0) years and mean body weight (26.7±7.6) kg. The pressure gradient across pulmonary valve was (62.9±11.9) mmHg and annulus diameter (14.5±1.5) mm which were measured by transthoracic echocardiography before procedure. All patients underwent percutaneous balloon pulmonary valvuloplasty by transesophageal and transthoracic echocardiographic guidance under general anesthesia and endotracheal intubation. The range of balloon/annulus ratio was 1.2-1.5. The outcomes of valvuloplasty were evaluated by catheter measuring and echocardiography after procedure. Follow-up was conducted by transthoracic echocardiography at 1 month after procedure. Results All cases were successfully treated with percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance. The balloon diameter was (19.9±2.3) mm, balloon/annulus ratio 1.37±0.06 and postoperative pulmonary transvalvular pressure (15.5±4.3) mmHg. Mild pulmonary valve regurgitation occurred in 2 patients. All patients survived without peripheral vascular damage or cardiac perforation. Hospitalization duration was (3.5±0.8) days. During follow-up, pulmonary transvalvular pressure measured by transthoracic echocardiography was (16.3±4.7) mmHg. Conclusions Echocardiography-guided percutaneous balloon pulmonary valvuloplasty is both safe and effective so that it avoids the injuries of radiation and contrast agents. Key words: Pulmonary valve stenosis; Percutaneous balloon pulmonary valvuloplasty; Echocardiography