Effect And Follow-up Of 266 Children With Pulmonary Stenosis Treated By Percutaneous Balloon Pulmonary Valvuloplasty

Objective: To evaluate the efficacy of percutaneous balloon pulmonary valvuloplasty(PBPV)in the treatment of pulmonary stenosis(PS)in children,and to follow up the prognosis of children with PBPV after mid-term and long-term follow-up,and analyze its influencing factors.Methods: From June 2008 to October 2018,266 children with PS were selected from the Department of Cardiovascular Medicine,Children's Hospital of Chongqing Medical University,who underwent PBPV,aged 22 days to 14 years and 3 months,and followed up for 1 to 5 years.Patients' hospitalization data,outpatient mid-and long-term follow-up data,and echocardiographic data of healthy children of the same age during the same period were collected and statistically analyzed.Results: A total of 266 children with PS were collected,including 144 males and 122 females,aged 22 days to 14 years and 3 months [(2.91±2.93)years old];262(98.5%)of the 266 patients successfully underwent PBPV,and the transpulmonary valve pressure difference(? P)was preoperatively,24 h postoperatively,6 months postoperatively,1 yearpostoperatively,2 years postoperatively,and 5 years postoperatively respectively are(62.84±28.21)mmHg(1mmHg= 0.133KPa),(29.13±14.96)mmHg,(23.81±14.96)mmHg,(20.67±12.72)mmHg,(19.34±10.62)mmHg,(19.07±15.15)mmHg,? P at 24 hours after surgery was significantly lower than that before surgery,and the difference was statistically significant(P <0.01).During the mid-and long-term follow-up,most children's ?P can be further decreased.Logistic regression analysis shows whether there is annulus dysplasia or right ventricular outflow tract obstruction,the degree of stenosis,and ?P immediately after surgery.Risk factors for long-term curative effect,the restenosis rate was 8.8%(3/34cases)during the 5-year follow-up;the incidence of pulmonary valve regurgitation was 47.1%,which was higher than that before and 24 hours after surgery.During the follow-up,it gradually decreased;during the5-year follow-up,the right ventricular diastolic diameter [(14.20±1.40)mm]was not significantly larger than that of healthy peers [(13.30 ± 0.67)mm]during the same period(t = 1.833,P = 0.56).Conclusion: PBPV can effectively alleviate right ventricular load,improve cardiac function and quality of life of children.The incidence of serious postoperative complications and restenosis is low,and the effect of mid-term and long-term follow-up is good.It can be used as the preferred treatment for PS,but it should be noted that longer-term follow-up and monitoring.