PULMONARY VALVE DILATATION
in pediatrics

What is pulmonary valve dilatation?

Pulmonary valve dilatation is a medical procedure that aims to treat pulmonary stenosis, a condition where the pulmonary valve is too narrow, restricting blood flow from the heart to the lungs. This procedure is performed by inserting a catheter with a balloon at its tip through the femoral vein and guided to the heart. Once inside the valve, the balloon is inflated and separates the valve cusps, allowing better blood flow .

Pulmonary dilatation can be performed at birth, if the newborn's adaptation to extra-uterine life is difficult (cyanosis), or during childhood if pulmonary stenosis affects the child's growth or ability to exercise.

Performing pulmonary valve dilatation:

Pulmonary dilatation is performed in the catheterization room. The child is laid flat and given general anesthesia so as not to move during the procedure. The doctor performs a venipuncture in the groin and inserts a thin catheter. The catheter is guided to the heart. An inflatable balloon is positioned at the pulmonary valve. Then, the balloon is inflated to widen the valve and improve blood flow. At the end of the procedure, the groin is compressed for about ten minutes and then a pressure bandage is applied. The child is monitored in the recovery room until he or she is fully conscious and then returned to the parents. Feeding is only allowed two hours after the end of the procedure to avoid the risk of aspiration. Discharge is usually the next day after an ultrasound check.

Are there any risks associated with pulmonary valve dilatation?

Despite technical progress and the experience of doctors, cardiac catheterization to dilate the pulmonary valve carries, as with any invasive or surgical procedure, a risk of incidents or accidents:

• Allergic complications: Most often linked to the use of iodinated radiological products or local anesthetics. If you have already experienced allergic manifestations, it is imperative to inform your doctor.

• Complications at the puncture site of the vein: The most common complication is the formation of a bruise or hematoma at the puncture site which can persist for several days, but is usually without consequence. Also, thrombosis, i.e. occlusion of the vein, can be mentioned.

• Cardiac and vascular complications: During the examination, palpitations may occur due to a rhythm disorder. Serious complications include cardiac perforation and tricuspid valve tear. These are rare but not negligible in the context of the emergency and the low weight of the infant.

• Failure of valvular dilation: Quite rare, it generally redirects the diagnosis towards a supravalvular stenosis, that is, arterial, which in this case requires surgical management.

What benefits can be expected from pulmonary valve dilatation?

Dilation of the pulmonary valve offers several benefits for the child:

1. Normal height and weight growth.

2. Improved exercise capacity: The child will have no limitations when playing and running.

3. Improved cognitive abilities: The child will have fewer difficulties in learning and performing.