Results of balloon dilation valvuloplasty for pulmonary stenosis have been excellent. This technique was developed in the mid-1980s, and significant experience has been gained in pediatric heart centers.
Importantly, balloon dilation cannot make an abnormal valve "normal." Instead, the procedure decreases the degree of pulmonary valve obstruction from severe to mild in the large majority of patients.
For children and adolescents with "typical" pulmonary valve stenosis, a single balloon dilation procedure is usually the only therapy ever needed. It is rare that an older child will have return of significant pulmonary valve obstruction following a successful balloon dilation procedure.
Newborns and young infants with very severe pulmonary valvar obstruction will also have an excellent response to balloon dilation, unless the valve is underdeveloped in size.
However, recurrence of significant pulmonary stenosis does occur in approximately 5 percent to 10 percent of children within 10 years of intervention. Occasionally, these patients may require a second balloon dilation, or an open-heart surgical procedure if the valve is small.
The long-term outcomes for open-heart surgery in patients with severe pulmonary valvar stenosis are also excellent.
Because balloon dilation is usually the only treatment necessary for most patients, open-heart surgery is generally only performed in patients with more complex forms of pulmonary valve obstruction.
However, patients with very thick valve leaflets or underdeveloped pulmonary valve sizes also have an outstanding long-term outcome following open-heart surgical repair. If there is no other associated heart disease, these children are expected to lead normal, active lives.
It is important that all children with pulmonary valve stenosis, even after very successful balloon dilation or open-heart surgery, be re-evaluated at regular intervals.
Long-term follow-up with evaluation by a qualified cardiologist is essential to helping provide the highest quality outcome for patients with pulmonary valve stenosis.