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| |  Twenty-Year Follow-Up for Pulmonary Balloon Valvuloplasty Patients Indicates Success, No Need for Re-Intervention: Presented at SCAI By Carole VanSickle Ellis LAS VEGAS -- May 14, 2009 -- A 20-year follow-up study of patients who had balloon valvuloplasty procedures as children has concluded that the process, which already had established procedural and short-term documented success, is also successful in the long term, according to a study presented here on May 8 at the 32nd Annual Scientific Sessions of the Society for Cardiovascular Angiography and Interventions (SCAI). The study dealt with patients who had undergone the procedure at fairly young ages, and found that very few in the sample group needed repeat procedures and those who did, needed them in the near future. None needed repeat procedures after the first few years, and their cardiovascular health remained strong and even improved as the years passed. Wolfgang Radtke, MD, Cardiac Catheterization Laboratory, Nemours Cardiac Center, Wilmington, Delaware, and colleagues evaluated the medical records of all paediatric patients who had pulmonary valvuloplasty between the years of 1984 and 2002 at the Kinderkardiologie Kiel, Kiel, Germany, and at the Children's Heart Center in Charleston, South Carolina. Patients were divided into 2 groups. Group 1 consisted of patients that had surgery less than 10 years ago (n = 239), and group 2 consisted of patients who had undergone the procedure 10.2 to 38.5 years ago (n = 72). On average, the length from treatment for the long-term group was 13.7 years and the patients had an average age of 18 years. Data was collected in the form of catheterisation reports, follow-up information from outpatient and inpatient records, follow-up catheterisation reports, and echocardiographic reports. Of the patients in group one, 9.6% were unavailable for follow-up; 0.9% had died within a few weeks of surgery, 5.6% needed another valve surgery an average of 2.6 months after the procedure, and 4.2% of these patients had a repeat pulmonary balloon valvuloplasty an average of 11.9 months later. However, it should be noted that infants can tend to need more surgery because their defects are hard to treat because of their size and the relative complexity of the defect, said Dr. Radtke. For group 2 an initial reduction in pressure gradients was seen from 70.3 mm Hg to 22.5 mm Hg. Decades later, the pressure gradient was 14.9 mm Hg. All patients in the group were free of symptoms and medications, and in 66% of the patients blood regurgitation was rated absent, trivial or mild. Using echocardiography, the ventricles were examined for enlargement with the results being that 85% of the patients had no more than mild right ventricular enlargement. The group plans to continue the study for additional decades, but the results of this 10- to 20-year follow-up show "excellent outcome with no need for re-intervention," stated the researchers in their report. [Presentation title: 20-Year Follow-Up After Pulmonary Balloon Valvuloplasty. Abstract 426]
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