Long-term follow-up of patients after surgical treatment for isolated pulmonary valve stenosis

OBJECTIVE: To determine the long-term outcome of patients after surgical repair for pulmonary valve stenosis (PVS). PATIENTS AND METHODS: Fifty-three patients (30 males; mean +/- SD age, 10 +/- 13 years; range, 5 days to 50 years) were Identified who had surgical treatment for PVS between 1951 and 1982. The status of each patient was determined by medical record review. RESULTS: The mean +/- SD age at follow-up was 43 +/- 15 years (age range, 19-77 years). Mean follow-up was 33 years (range, 18-51 years). At a median follow-up of 34 years, 35 reinterventions had been performed in 28 patients (53%), including pulmonary valve replacement for free pulmonary regurgitation in 21 patients (mean interval after Initial surgery, 33 years; range, 14-45 years), open valvotomy in 5 and pulmonary balloon vaivuloplasiy in 3 for residual PVS, closure of atrial septal defect in 2, right ventricular outflow tract reconstruction in 1, closure of iatrogenic ventricu: septal defect In 1, ligation of aortopulmonary fistula in 1, and tricuspid valve annuloplasty with simultaneous coronary artery bypass grafting in 1. In addition, atrial and ventricular arrhythmias were common, occurring in 20 patients (38%). Patients who Underwent reintervention were more likely to have undergone closed, pulmonary valvotomy as the initial repair (P = .008). CONCLUSION: Although overall survival after surgical treatment of isolated PVS remains excellent, many patients undergo late reintervention after 30 years of follow-up, emphasizing the need for lifelong cardiac follow-up.