Predictors of Reintervention in Infants with Severe Pulmonary Stenosis Undergoing Balloon Pulmonary Valvuloplasty

Abstract

Abstract Background Balloon pulmonary valvuloplasty is the treatment of choice for patients with moderate to severe pulmonary valve stenosis. The procedure is not free of complications and there is still a significant rate of reintervention. Objective Describe the short and midterm outcomes in infants undergoing balloon dilatation for severe P.S, to determine predictors of reintervention. Patients and Methods All infants with severe congenital valvular PS who underwent interventional cardiac catheterization between October 2020 and april 2021 were reviewed Prospectively. We performed a comparison between those who required reintervention and those who did not, to identify the predictors of reintervention. Results thirty five infants were included, having severe PS. Twenty-one infants 21 (60.0%) were males, the mean age was ranged from 7 days to 12 months (mean; 6.08 ± 3.95 months), and the mean weight was 7.37 ± 1.95 kg. twenty infants(20%) required reintervention. Small pulmonary valve annulus diameter with Mean ± SD 5.14 ± 1.07 mm; p = 0.001 and Pulmonary valve annulus z-score were significantly smaller in those who needed reintervention Median(IQR) -2.50 (-3.10 – -2.50), pvalue 0.001, Other predictors for reintervention included, Residual high pulmonary artery pressure after BPV with Median (IQR) 54 (35 – 55) mm Hg, p-value0.001.The immediate and short-term outcome of PBPV was better in patients who did not need reintervention. Conclusion Interventional cardiac catheterization shows favorable outcome for patients with severe PS. Predictors for reintervention included the small pulmonary valve annulus diameter and pulmonary valve Z-score, A minor immediate drop in pressure gradient across the pulmonary valve post-intervention has higher rate of reintervention.