Therapeutic cardiac catheterization for pulmonary valve and pulmonary artery stenosis

Abstract

At C.S. Mott Children's Hospital, percutaneous balloon angioplasty for pulmonary valve or pulmonary artery stenosis accounts for approximately 40 per cent of all therapeutic transcatheter procedures performed in our laboratory. Percutaneous balloon valvuloplasty offers a highly successful nonsurgical approach to the treatment of children with isolated congenital valvar pulmonary stenosis. In these children, balloon valvuloplasty generally reduces the peak systolic pressure gradient by more than 50 per cent and should be considered the treatment of choice. Balloon angioplasty provides substantial anatomic and hemodynamic benefit in approximately 50 to 60 per cent of children with peripheral pulmonary artery stenosis. It is most often successful in treating naturally occurring pulmonary artery stenoses in children with tetralogy of Fallot. Since the surgical alternatives are difficult and often unsuccessful, balloon angioplasty offers a valuable form of treatment for many children with significant pulmonary artery stenosis or hypoplasia.