Treatment of congenital pulmonary valve stenosis in a middle-aged adult

    Authors

    Keywords

    middle-aged adult, pulmonary valve stenosis, balloon valvuloplasty

    DOI

    https://doi.org/10.15836/ccar2016.466

    Full Text

    **Introduction:** Pulmonary valve stenosis (PS) is a heart valve disorder in which outflow of blood from the right ventricle (RV) of the heart to the lungs is obstructed at the level of pulmonic valve. It is usually congenital and the prevalence of PS has been reported at 0.6 to 0.8 cases per 1000 live births. It can be due to isolated valvular (90%), subvalvular or supravalvular obstruction, or it may be associated with other congenital heart disorders. 1982 is the year when the technique of percutaneous balloon pulmonary valvuloplasty (BVP) was introduced and replaced surgical methods of treatment. (1, 2) **Case presentation:** We present a case of 67-year-old man with congenital PS. He complained of occasional chest tightness and shortness of breath. There was Grade V/VI middle systolic crescendo-decrescendo murmur over the pulmonary area. Computed tomography, of the chest revealed marked enlargement of the left pulmonary artery (up to 43mm). Transthoracic echocardiography (TTE) revealed valvular PS (Vmax 5.66m/s) with RV wall hyperthropy (11-12mm) and transpulmonary pressure gradient (PG) was 128 mmHg. BPV was performed three days after admission. Initial hemodynamic measurement reported RV pressure of 140/0/12 mmHg and PA pressure 30/16/20 mmHg. After these measurements, balloon valvuloplasty was performed with subsequent decrease of RV pressure to 60/0/10 mmHg. At the follow up visit one year later the patient was asymtopmatic, and on TTE PG measured 51 mmHg with mild pulmonary regurgitation. **Conclusion:** Balloon valvuloplasty is the treatment of choice in the management of moderate to severe PS in adults with good short and long-term results..

    Literature

    1. Idrizi S, Milev I, Zafirovska P, Tosheski G, Zimbakov Z, Ampova-Sokolov V, et al. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience. Open Access Maced J Med Sci. 2015 Sep 15;3(3):408–12. https://doi.org/10.3889/oamjms.2015.089
    2. Lin SC, Hwang JJ, Hsu KL, Lee CM, Wang JK, Tseng CD, et al. Balloon Pulmonary Valvuloplasty in Adults with Congenital Valvular Pulmonary Stenosis. Acta Cardiol Sin. 2004;20:147–53.
    Cardiologia Croatica
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    Treatment of congenital pulmonary valve stenosis in a middle-aged adult

    Extended Abstract
    Issue10-11
    Published
    Pages466
    PDF via DOIhttps://doi.org/10.15836/ccar2016.466
    middle-aged adult
    pulmonary valve stenosis
    balloon valvuloplasty

    Authors

    Ivana JurinORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Boris StarčevićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Dražen ŠebetićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Mario UdovičićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ana Jordan*ORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Aleksandar BlivajsORCIDUniversity Hospital Dubrava, Zagreb, Croatia

    *Correspondence email: anazovko4@gmail.com

    Full Text

    Introduction: Pulmonary valve stenosis (PS) is a heart valve disorder in which outflow of blood from the right ventricle (RV) of the heart to the lungs is obstructed at the level of pulmonic valve. It is usually congenital and the prevalence of PS has been reported at 0.6 to 0.8 cases per 1000 live births. It can be due to isolated valvular (90%), subvalvular or supravalvular obstruction, or it may be associated with other congenital heart disorders. 1982 is the year when the technique of percutaneous balloon pulmonary valvuloplasty (BVP) was introduced and replaced surgical methods of treatment. (1, 2)

    Case presentation: We present a case of 67-year-old man with congenital PS. He complained of occasional chest tightness and shortness of breath. There was Grade V/VI middle systolic crescendo-decrescendo murmur over the pulmonary area. Computed tomography, of the chest revealed marked enlargement of the left pulmonary artery (up to 43mm). Transthoracic echocardiography (TTE) revealed valvular PS (Vmax 5.66m/s) with RV wall hyperthropy (11-12mm) and transpulmonary pressure gradient (PG) was 128 mmHg. BPV was performed three days after admission. Initial hemodynamic measurement reported RV pressure of 140/0/12 mmHg and PA pressure 30/16/20 mmHg. After these measurements, balloon valvuloplasty was performed with subsequent decrease of RV pressure to 60/0/10 mmHg. At the follow up visit one year later the patient was asymtopmatic, and on TTE PG measured 51 mmHg with mild pulmonary regurgitation.

    Conclusion: Balloon valvuloplasty is the treatment of choice in the management of moderate to severe PS in adults with good short and long-term results..

    Literature

    1. 1.
      Idrizi S, Milev I, Zafirovska P, Tosheski G, Zimbakov Z, Ampova-Sokolov V, et al. Interventional Treatment of Pulmonary Valve Stenosis: A Single Center Experience. Open Access Maced J Med Sci. 2015 Sep 15;3(3):408–12.DOI
    2. 2.
      Lin SC, Hwang JJ, Hsu KL, Lee CM, Wang JK, Tseng CD, et al. Balloon Pulmonary Valvuloplasty in Adults with Congenital Valvular Pulmonary Stenosis. Acta Cardiol Sin. 2004;20:147–53.