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Meng-Luen Lee,Jui-Wen Peng,Guo-Jhueng Tu,San-Yi Chen,Jyong-You Lee,Shu-Lin Chang 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.3
Purpose: We report herein major determinants and long- term outcomes of balloon dilatation (BD) for 27 pediatric patients with isolated native valvular pulmonary stenosis (VPS). Materials and Methods: From May 1997 to May 2003, 27 pediatric patients with VPS (pressure gradients≧ 40mmHg) were enrolled in this retrospective study. Single- balloon maneuver was applied in 26 patients, and double- balloon maneuver in 1. After BD, the pressure gradients were documented simultaneously by pullback maneuver by cardiac catheterization and echocardiography within 24 hours, at 1- month, 3-month, 1-year, and 4-to-10-year follow-ups. Results: Before BD, the echocardiographic gradients ranged from 40 to 101mmHg (61±19, 55), and from 40 to 144mmHg (69 ±32, 60) by pressure recordings. After BD, the gradients ranged from 12 to 70mmHg (29±13, 27) by pressure recording (p<0.001), and from 11 to 64mmHg (27±12, 26) by echocardiography within 24 hrs (p<0.001). The ratios of the systolic pressure of the right ventricle to those of the left ventricle were 55 to 157% (89±28, 79%) before BD, and 30 to 79% (47±13, 42%) after BD (p<0.001). Follow-up (7.7±5.7, 4.5 years) echocardiographic gradients ranged from 11 to 61mmHg (25±11, 24). Two patients did not have immediate success owing to infundibular spasm. Improved right ventricular compliance could be accounted for the ultimate success in these 2 patients. The ultimate successful rate was 100%. Conclusion: BD can achieve excellent long-term outcomes in the pediatric patients with isolated native VPS.