Percutaneous Balloon Pulmonary Valvuloplasty

Abstract

Percutaneous balloon pulmonary valvuloplas ty has recently been developed as a safe procedure for relief of stenosed pulmonic valves. Recent reports suggest that it has become an established alternate procedure to open heart surgery for the management of pulmonary valve stenosis. Indeed it is now recommended as a procedure of first choice in the relief of congenital isolated pulmonary valve stenosis.

CASE REPORT:

A 13 years old boy with a 2-year history of easy fatiguability and shortness Of breath on moderate to severe exertion, was referred from Peshawar for surgical pulmonary valvotomy.

Electrocardiogram showed right ventricular hypertrophy and X-ray of the chest showed prominent pulmonary artery conus. A two De chocardiography was done which showed thicke ned pulmonic valve and there was valvular doming during systole. The pulmonary root diameter at the level of valve insertion was 25 mm.

Discussion:

Isolated pulmonary valve stenosis is a common congenital cardiac defect and comprises about 10 per cent of all congenital heart diseases (15). rn our own series of children under 12 years of age it had a similar incidence. Surgical valvoto my is well established and can be performed at low risk. However the surgical approach involves a sternotomy, open heart surgery and use of cardiopulmonary lbypass, exposure to blood products, a surgical scar that is cosmeticaLly displeasing and 2 weeks of hospitalization and approximate cost of 60,000 rupees. use of minimum number of catheters. Pulmonary valve annulus diameter estimation must be made well in advnce with echocardiography and with angiography at the time of catheterization for selection of appropriate size balloon catheter. It is concluded that stencksed pulmonary valve dilatation by balloon catheters is a safe and reliable procedure.