Balloon Valvuloplasty in Pakistan

Abstract

The era of balloon valvuloplasty has started in Pakistan (Pakistan Heart Journal Vol. 20 No. 4, Oct. —. Dec. 1987. Percutaneous Balloon Pulmonary Valvuloplasty: A. La!, A. Faruqui and K. Aziz). Presently, balloon valvuloplasties are being routinely done at least in Karachi and Lahore. What then appears the status and future of balloon valvuloplasty in our environment? As Tricuspid Stenosis is a rarer situation, for the most part we are talking about Aortic Stenosis, Mitral Stenosis and Pulmonic Stenosis. Let us examine each of these situations. Balloon dilatation of Aortic Stenosis in adults can be done reasonably safely and produces adequate immediate relief of gradient. However, the long term followup has shown a very high rate of recurrence of Aortic Stenosis within six months. While balloon dilatation for Aortic Stenosis remains a viable alternative, just like Aortic Valvotomy in adults, it may prove increasingly disappointing.In conclusion, Balloon Valvuloplasty has made a significant impact in the way purely stenotic valve lesions are being treated. Ballooning is the treatment ofchoice for Pulmonary Stenosis. It is an option in some cases of Aortic Stenosis. Finally, despite the theoretic advantage, Ballooning is not cost effective in our circumstances for the treatment of Mitral Stenos is.