LONG-TERM (10 TO 13 YEARS) FOLLOW-UP STUDY AFTER TRANSVENTRICULAR PULMONARY VALVULOTOMY FOR PULMONARY STENOSIS WITH INTACT VENTRICULAR SEPTUM

A long-term follow-up study on 46 patients with pulmonary stenosis and intact ventricular septum who survived transventricular pulmonary valvulotomy performed at the Johns Hopkins Hospital between 1949 and 1951 was carried out; the mean follow-up period was 11.2 years. Preoperatively these patients were severely incapacitated, 76 per cent were cyanotic, 80 per cent had cardiomegaly, and 52 per cent were in congestive cardiac failure. All 46 survivors of the pulmonary valvulotomy were alive at the time of the present evaluation. In almost half of these patients the long-term results were excellent and the pulmonary stenosis appeared to be virtually relieved. The results were good in 26 per cent of the patients; these patients also had remarkable subjective and objective improvement but still presented signs of residual right ventricular hypertrophy on the electrocardiogram. In 26 per cent of patients the long-term results were poor; seven of these patients have been reoperated upon. Twenty-nine per cent of the patients developed pulmonary insufficiency after surgery; there was no evidence, however, that this complication affected the long-term results. The long-term studies indicate that for patients with mild to moderate pulmonary valvular stenosis a transventricular pulmonary valvulotomy gives extremely satisfactory results. For patients with congestive cardiac failure, cyanosis, or severe incapacity, the long-term results frequently are less satisfactory.