Immediate and Intermediate Term Outcome of Percutaneous Balloon Pulmonary Valvuloplasty
Authors: Bhuiyan Dr. Mohammad Nazmul Islam , Yasmin Dr. Mahamuda , Khan Dr. Md. Ashfaque Ahemmed , Hossain Dr. Mofazzol , Das Dr. Bijoy Kumar , Tanjin Dr. Ishrat , Hossain Dr. Khandoker Mohammad 
Published: December 2022

Background: Pulmonary stenosis (PS) is one of the common congenital heart diseases (CHD) with the incidence of 8-10% of all CHD. Percutaneous balloon pulmonary valvuloplasty (PBPV) is considered as the treatment of choice for these purposes. It is a safe, effective and less time-consuming procedure. But in Bangladesh, we have very limited research-based data regarding the effectiveness of percutaneous balloon pulmonary valvuloplasty in treating pulmonary stenosis. Aim of the Study: The aim of this study was to evaluate the immediate and intermediate term outcome of percutaneous balloon pulmonary valvuloplasty in treating pulmonary stenosis. Methods: This was a hospital based prospective observational study conducted from January 2021 to December 2021 at Combined Military Hospital (CMH) Dhaka, Bangladesh. Interventional work was completed during the first 06 months and follow up was completed during the remaining 06months. A total of 50 patients were evaluated who had undergone PBPV by detailed clinical history, thorough physical examination and relevant investigations, like- CXR, ECG and Echocardiography. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 24 program as per necessity. Results: In this study, two cases were undergone double intervention. During the procedure all cases developed bradycardia and 5(10%) developed cardiac arrest. Immediately after the procedure RV pressure was reduced and PA pressure was increased and PS gradient was reduced dramatically. The peak-to-peak pressure gradient across pulmonary valve reduced from pre-procedure value of 76.8± 5.41mmHg to post procedure value of 18.14±6.88 mmHg which is statistically significant (P<.00001). On D1 Echocardiographic follow up, 13 cases developed trivial pulmonary regurgitation (PR) and after that at D30 follow up, 1 patient developed mild PR out of these 13. In our study 46(92%) cases were successful and 4(8%) and procedure failed; out of these 04 procedures failed cases 3(6%) cases developed restenosis, one patient on D30 Echo and two cases on D90 Echo, D180 Echo do not develop any complications. Other than 3 restenosed cases all 47(94%) cases were leading healthy life without any unwanted events. All the restenosed cases had dysplastic pulmonary valve (PV). RV function of 50(100%) cases was good both in pre and post procedure as evidenced by normal TAPSE ranges from 15-22. Chest X- Ray (CXR) and Electrocardiography was found normal in 180 days follow up. Conclusion: Percutaneous balloon pulmonary valvuloplasty (PBPV) is already considered as the gold standard in the treatment of valvular pulmonary stenosis. This patient friendly procedure should be taken as a first line interventional treatment for congenital as well as post-operative valvular pulmonary stenosis. This study showed excellent outcome among study population without major complications and mortality and recommend PBPV as the first-choice therapy in our setup.