Objectives: To evaluate the efficacy and safety of balloon pulmonary valvuloplasty (BPV) in children. Design, setting and method: This is a retrospective review of 101 consecutive patients with pulmonary stenosis who underwent BPV at the Lady Ridgeway Hospital for Children over a period of 42 months. Four patients were excluded as they had complex cardiac problems. Data was obtained from Excel based cardiac catheterization reports in the Department of Paediatric Cardiology. Reduction of pressure gradient across pulmonary valve to less than 25 mmHg was defined as a successful procedure. Results: Ninety seven BPVs were performed in 94 patients. The mean age, bodyweight and height were 19 months, 9.5 kg and 80 cm respectively. Sex distribution was equal. The mean of the balloon to pulmonary annular ratio was 108% (range 50-150%). After the BPV, mean peak to peak pressure gradient across the pulmonary valve dropped from 70±29 mmHg to 24.7±16.8 mmHg. Overall success rate was 55.7%. Mortality was 3.1%. Major complications were haemopericardium (4.1%), bradycardia (2%) endocardial damage (1%) and pulmonary oedema (1%). The correlation between pulmonary annulus on echocardiography and angiography was significant (p<0.01).
A one day old term neonate weighing 2.8 kg. was transferred to our unit from Puttalam with respiratory distress and cyanosis. He had no cardiac murmurs and no features of heart failure. The chest x-ray revealed massive cardiomegaly (Figure 1).
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