Srpski arhiv za celokupno lekarstvo 2014 Volume 142, Issue 9-10, Pages: 542-546
https://doi.org/10.2298/SARH1410542P
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Efficacy and safety of balloon valvuloplasty as a treatment of choice for pulmonary stenosis in children and adolescents
Parezanović Vojislav 
(School of Medicine, Belgrade + University Children’s Hospital, Belgrade)
Djukić Milan (School of Medicine, Belgrade + University Children’s Hospital, Belgrade)
Dželebdžić Sanja (University Children’s Hospital, Belgrade)
Ilisić Tamara (University Children’s Hospital, Belgrade)
Stefanović Igor (University Children’s Hospital, Belgrade)
Vukomanović Goran (University Children’s Hospital, Belgrade)
Jovanović Ida (School of Medicine, Belgrade + University Children’s Hospital, Belgrade)
Ilić Slobodan (School of Medicine, Belgrade + University Children’s Hospital, Belgrade)
Vulićević Irena (University Children’s Hospital, Belgrade)
Kalanj Jasna (University Children’s Hospital, Belgrade)
Introduction. Pulmonary artery stenosis (PS) is a congenital heart defect
which occurs in 10% of all congenital heart defects. Pulmonary balloon
valvuloplasty (BVP) has been the treatment of choice of PS over the last 30
years. Objective. The purpose of this study was to evaluate the efficacy of
this method based on middle-term hospital follow-up, and safety of BVP based
on our experience. Methods. The study included 88 patients diagnosed with PS.
The patients were divided into three groups based on the severity of the
disease. Also, they were divided into two age groups in order to analyze the
frequency of complications. Hemodynamic measurements and echocardiography
results were recorded before, 24-36 hours after BVP and at the end of
follow-up. Results. The studied group involved patients of average age
3.75±4.3 years (20 days to 17 years). Immediately after BVP a significant
decrease of pressure gradient across the pulmonary valve (PV) was recorded in
all patients; this result was similar in all 3 groups of patients regardless
of the severity of stenosis (p<0.001). Complications of BVP occurred most
commonly in children up to 12 months of age (ventricular tachycardia 4.5% and
supraventricular tachycardia 6.8%). Pulmonary valve insufficiency after
dilatation occurred in 6.6% of cases, and was most common in children aged up
to 12 months. In 87 (98.9%) patients BVP was a definitive solution, and a
significant residual stenosis was not recorded during follow-up. Conclusion.
BVP is a safe and effective procedure in the treatment of isolated PS in
children, regardless of the severity of stenosis but also regardless of
patients’ age.
Keywords: balloon pulmonary valvuloplasty, pulmonary stenosis, children