Balloon Pulmonary Valvuloplasty in Tetralogy of Fallot: Effects on Growth of Pulmonary Annulus and Transannular Patch

Background: Balloon pulmonary valvuloplasty and its benefit on the growth of pulmonary annulus and pulmonary artery in tetralogy of Fallot (TOF) patients remains controversial. The purpose of the present study was to determine the growth of pulmonary valve annulus and pulmonary artery and to evaluate the need of transannular patch during total surgical correction in patients with tetralogy of Fallot (TOF) after balloon pulmonary valvuloplasty. Material and Method: Fifty-one severely hypoxic TOF patients, who underwent balloon dilatation of pulmonary valve, were included in the present study. The clinical outcomes, oxygen saturation, and echocardiographic parameters before and after balloon dilatation were analyzed. Results: There were 33 males and 18 females. The mean age was 3 years 5 months old (range, 1 month-15 years 8 months old). The mean oxygen saturation increased from 73.9 + 9.1 to 84.8 + 6.7% immediately after the procedure (p-value < 0.05). There was no serious procedural-related complication. At the mean follow-up period of 2 years and 4 months, the mean Z-score of pulmonary annulus size increased from -2.56 SD to -1.87 SD (p-value < 0.05) and the right pulmonary artery size from -0.29 SD to + 0.46 SD (p-value < 0.05). Thirty-seven patients (66.1%) underwent corrective surgery. Pulmonary transannular patch was performed in 11 of 37 patients (29.7%). Conclusion: Pulmonary valve dilatation in patients with TOF is safe. It promotes the growth of the pulmonary valve annulus and pulmonary artery and may decrease the need of transannular patch at the time of surgical correction. Keywords: Balloon pulmonary valvuloplasty, Tetralogy of Fallot (TOF)