Mild to moderate pulmonary valvular stenosis in infant sometimes improves to the condition unnecessary to do PTPV: Doppler echocardiographic observation.

The purpose of this study is to clarify the natural history of the valvular pulmonary stenosis (PS) from the standpoint of the indication for percutaneous transvenous pulmonary valvuloplasty (PTPV). We retrospectively analyzed age-dependent changes of the peak velocity in the pulmonary artery (peak V) using Doppler echocardiography (Doppler), and some other echocardiographic and clinical findings in 55 children with mild to moderate PS. Groups A, B, and C consisted of those who had peak V above 3.54 m/sec, between 3.54 and 2.74 m/sec, and less than 2.74 m/sec, respectively. Peak V of 42 patients who had the first Doppler study before 1 year of age decreased from 2.61 +/- 0.66 to 2.27 +/- 0. 80 m/sec (p < 0.01). One infant in group A, that initially included 3 children, has improved to group B. Among the 15 patients in group B, one patient deteriorated to group A, and peak V of 10 infants reduced to less than 2.74 m/sec. In group C, peak V of 2 infants increased above 2.74 m/sec. Other than age at the first examination, we could not find specific indications that could predict the reduction of peak V. Mild to moderate PS younger than 1 year of age sometimes markedly improves; the invasive procedure of PTPV may not be necessary in non-critical infant patients with mild to moderate PS.