Phophi Raphulu
University of Witwatersrand, South AfricaPresentation Title:
Balloon valvuloplasty for valvar pulmonary stenosis: A 30-year experience at a large tertiary-level hospital, Southern Africa
Abstract
Background: Congenital pulmonary valve stenosis (PS) is one of the most common congenital cardiac defects, accounting for 8 – 12% of all congenital cardiac defects. Percutaneous balloon pulmonary valvuloplasty (PBPV) has been the preferred treatment since its introduction in 1982.
Aim: To evaluate the efficacy and safety of PBPV over the last 3 decades at a single institution.
Method: A retrospective, descriptive analysis was conducted at Chris Hani Baragwanath Academic Hospital (CHBAH) in Southern Africa to evaluate patients who underwent PBPV between 1985 and 2019.
Results: During the study period, 68 patients underwent balloon valvuloplasty for moderate to severe pulmonary stenosis. Patients were selected using echocardiographic criteria. The mean pulmonary valve annulus measured on angiography was 11.2 mm (SD 3.9) with a mean balloon size of 13.1mm (SD 4.4). The balloon size to pulmonary valve annulus ratio was 1.169:1. The median peak instantaneous gradient (PIG) before balloon valvuloplasty was 79mmHg (IQR 64-102mmHg) which decreased to 33mmHg (IQR 23-40mmHg) after balloon valvuloplasty (P<0.001). There was an 88% success rate.
Conclusion: Our study shows that PBPV is a safe and effective treatment of moderate and severe PS with a good outcome. Complications are rare if the procedure is well planned with appropriate balloon sizing, and anticipated complications such as pulmonary oedema and right ventricular outflow obstruction.
Biography
Dr Phophi Raphulu is a Paediatric Cardiologist and based at the Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. She is also a lecturer and undergraduate medical student coordinator at the University of Witwatersrand. Her special interests are Advanced Echocardiography, Fetal Cardiology and Paediatric Cardiac percutaneous interventions. Due to her interest in Fetal Cardiology, she spent some time in the Fetal Heart Program at the Children’s Hospital of Philadelphia. Dr Raphulu is the current chairperson of the African Female Paediatrician Network and also serves as a reviewer for South African peer reviewed journals.
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