Double balloon pulmonary valvuloplasty: Multi-track system versus conventional technique

Abstract

Objectives: To evaluate whether double balloon pulmonary valvuloplasty (DBPV) with the Multi-Track system (MTS) may help to simplify the procedure. Background: DBPV is usually required for patients with pulmonary valve stenosis with large annulus. However, it needs two venous accesses and can be technically demanding. Methods: From 07/03, 20 consecutive patients (19 ± 10 yrs) with typical pulmonary valve stenosis underwent DBPV using the MTS (G1). The results were compared with those achieved by conventional DBPV performed in a matched historical group of 28 patients (21 ± 11 yrs; P = NS) (G2). Results: MTS balloons were easily advanced through the skin and inflated across the valve. Similar results were observed in regards to residual gradients (12 ± 11 vs 14 ± 10 mm Hg; P = NS) and right ventricular to systemic pressures (0.35 ± 0.22 vs 0.37 ± 0.26; P = NS). Procedure and fluoroscopic times were significant lower in G1 (78 ± 24 vs 126 ± 28; 15 ± 12 vs 25 ± 8 min, respectively; both P < 0.001). There was no major complication. Median follow-up was 1.8 yr for G1 and 5 yr for G2 (P = 0.037). At the last visit, peak instantaneous gradient across the right ventricular outflow tract by echocardiography was a mean 22 ± 10 mm Hg for G1 and 25 ± 9 mm Hg for G2 (P = NS). No patient had severe pulmonary insufficiency or required reintervention. Conclusions: The use of the MTS helped to expedite the procedure providing satisfactory midterm clinical outcomes, similar to those observed with the conventional DBPV technique. © 2006 Wiley-Liss, Inc.