[Percutaneous pulmonary valvuloplasty with balloon catheter in a patient with severe pulmonary stenosis. First case carried out in Panamá].

Abstract

The authors report the clinical history of a 15 years old young man with severe congenital pulmonary valvular stenosis who was treated, for the first time in Panama, with percutaneous balloon pulmonary valvuloplasty (PBPV). The patient presented with an episode of syncope at rest. The EKG showed right ventricular hypertrophy (RVH) and suggested the presence, with the echocardiogram, of pulmonary systolic pressures higher than the systolic systemic pressures. The diameter of the interior pulmonary ring was estimated to 20 mm. The chest X-ray suggested the presence of RVH. Multiple premature ventricular systoles were detected by the Holter monitoring. Cardiac catheterization showed pressures of 150/12 mm Hg in the right ventricle (RV) and 24/9 mm Hg in the pulmonary artery (PA) with a transvalvular gradient of 126 mm Hg. PBPV was successfully done on 19 june 1993. The pressures in the RV were then 38/5 mm Hg and in the PA 25/7 mm Hg with a residual gradient of 13 mm Hg. Twenty minutes after completion of the procedure the patient experienced a hypertensive crisis and pulmonary edema, a complication of PBPV not previously reported in the literature.