Abstract
Congenital pulmonary valve stenosis is a common congenital heart disease. Isolated pulmonary valve stenosis comprises 8-10% of all congenital heart disease. While surgical pulmonary valvotomy has been available as a treatment since 1956, it requires a median sternotomy, use of cardiopulmonary bypass, and post-surgical ICU admission with multi-day hospitalization. Recognizing the potential advantages of a less invasive approach, the first attempts at percutaneous catheter-based dilation of stenotic pulmonary valves were performed in the 1950s. As the technique was refined and catheter and balloon technology have advanced, the results of balloon pulmonary valvuloplasty have improved and the approach has become the standard of care for treating pulmonary valve stenosis. The purpose of this article is to discuss the anatomy and physiology of pulmonary valve stenosis, describe the techniques and current technology, and review the outcomes of balloon pulmonary valvuloplasty.
Highlights
Congenital aortic stenosis makes up 5% to 6% of all congenital heart defects
The degree of aortic insufficiency does not worsen as a general rule (Figure 12); there is improvement seen in some patients suggesting better coaptation of the aortic valve leaflets after balloon dilatation
In the first series of 23 consecutive patients with valvar aortic stenosis, reported by Lababidi et al [11], the peak to peak systolic gradient across the aortic valve decreased from 113 +/- 48 mmHg to 32 +/- 15 mmHg (p
Summary
Congenital aortic stenosis makes up 5% to 6% of all congenital heart defects. It occurs four times more frequently in males than females. The pathology of stenosis varies, the most common is a bicuspid valve with commissural fusion. Unicuspid aortic valves are more prevalent in neonates with critical stenosis while bicuspid valves are common in childhood. Aortic stenosis is a progressive disorder with worsening severity of obstruction with increasing age. The treatment of choice for congenital aortic valve stenosis has varied from surgical valvotomy in the past to balloon aortic valvuloplasty at the present
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