Regression of infundibular hypertrophy after pulmonary valvuloplasty for pulmonic stenosis

Abstract

The first attempt at a nonsurgical pulmonary commissurotomy at cardiac catheterization occurred in 1951 and was performed by Rubio-Alvarez et al. 1 This procedure was forgotten until 1982 when Kan et al, 2 using a balloon catheter, successfully opened a stenotic pulmonary valve. Since then, the technique has been quickly and successfully adopted at most hemodynamic laboratories. Older patients with severe pulmonary stenosis (PS) and associated hypertrophy of the infundibulum of the right ventricle may be “unfavorable” candidates for valvuloplasty, because some surgeons have indicated that the infundibulum needs to be resected in these patients. However, some studies 3–6 showing that infundibular hypertrophy is reversible after surgical commissurotomy suggest that the same phenomenon might occur in patients submitted to pulmonary valvuloplasty. We have therefore performed pulmonary valvuloplasty in patients with severe PS and infundibular hypertrophy. Of 100 patients undergoing valvuloplasty, 33 had suprasystemic right ventricular pressures; they are the subject of this article.