Long-term Outcome Of Percutaneous Balloon Pulmonary Valvuloplasty In The Treatment Of Pulmonary Valve Stenosis For 30 Years In A Single Center

Objective:To evaluate the clinical application of percutaneous balloon pulmonary valvuloplasty(PBPV)in the treatment of pulmonary valve stenosis(PS)for 30 years.Methods:Since April 1986 to April 2016,a total of 1229 PBPV was performed in our hospital,and 655 patients with complete clinical data were followed up for more than 6 months.The average follow-up time was 2.55±1.30 years(0.5 to 11.5),the main follow-up measures include telephone follow-up and outpatient follow-up(echocardiographic assessment).Results:The pressure gradient(PG)measured immediately after catheterization in 1229 patients decreased from 74.40±29.64 mmHg to 25.05±8.62 mmHg,with an obviously dropping(P<0.05).In the subsequent follow-up,the PG was measured by ultrasound,which differential pressure is maintained at 21.91±17.22 mmHg on average.If the technical success criteria are PG<35 mmHg or the pressure difference drops by more than 60%after PBPV,the technical success rate reaches 98.5%(1211/1229).There were 3 intraoperative and perioperative deaths in this group(mortality rate 0.24%),and the incidence of other serious complications(including tricuspid valve rupture and more than moderate pulmonary regurgitation)was 0.4%(5/1229).At the time of echocardiographic follow-up,20 patients(3.0%)had a 1 degree increase in pulmonary valve regurgitation compared with 24 hours after operation.The incidence of restenosis was 0.5%(7/655)during follow-up.During the echocardiographic follow-up,20 patients(3.0%)had a 1 degree increase in pulmonary valve regurgitation compared with 24 hours after operation.The incidence of restenosis was 1.1%(7/655)during follow-up.Conclusion:Thirty years of clinical experience have shown that the PBPV as treatment for pulmonary stenosis has a satisfactory short,medium and long-term results,and the complication rates are low.Therefore,it can be considered as a mainstream technology in the era of Interventional therapy to deal with valvular disease in clinical.During the follow-up,a small number of patients' pulmonary regurgitation increase,requiring further clinical observation.