Surgical Evaluation of Percutaneous Transluminal Balloon Angioplasty and Valvuloplasty in Congenital Cardiovascular Anomalies

Abstract

Percutaneous transluminal bal loon angioplasty and valvuloplasty procedures for treatment of congeni tal cardiovascular anomalies were performed in 109 consecutive pa tients. Forty-two patients had balloon pulmonary valvuloplasty: the mean peak systolic gradient was reduced from 80 ± 35 mmHg to 23 ± 15 mmHg (p < 0.01). Thirty-seven pa tients had balloon aortic valvulo plasty : the mean gradient was re duced from 105 ± 43 mmHg to 28 ± 15 mmHg (p < 0.01). Thirty pa tients had balloon aortic coarctation angioplasty: the mean gradient was reduced from 47 ± 3.9 mmHg to 9.2 ± 1.3 mmHg (p < 0.01). Follow-ups of percutaneous balloon pulmonary valvuloplasty results in 15 patients (mean of 9.1 ± 1.2 months), of per cutaneous balloon aortic valvulo plasty in 17 patients (mean of 11.6 ± 1.9 months), and of percutaneous balloon aortic coarctation angio plasty in 14 patients (mean of 13 ± 4 months) revealed that gradients re mained significantly reduced (p < 0.01) in all groups. Elective op eration was performed upon 14 pa tients following percutaneous transluminal balloon procedures, and pulmonary valves were noted to be opened by commissural splitting, cusp tear, or cusp avulsion from the annulus. Aortic valves had commis sural splitting, and coarctation sites had intimal tears. No deaths oc curred. Percutaneous transluminal balloon valvuloplasty and angioplasty can aid in palliating selected congeni tal cardiovascular anomalies and de lay the time within which operative treatment is required.