Percutaneous pulmonary balloon valvuloplasty (PBV) remains the treatment of choice for pulmonary stenosis (PS).
This procedure is effective, safe and gives excellent results.
PA dissection has most commonly been described in patients with structural heart disease such as congenital disorders or rheumatismal involvement; and in those with pulmonary thrombosis and chronic obstructive pulmonary disease.
Catheter-induced PA dissection has been reported as extreme rare cause.
PBV was carried out on the patient with multipurpose A2 balloon number 15.
After the procedure, peak pressure gradient decreased to 37 mm Hg.
It is believed that the natural course of PA dissection is not known due to the paucity of cases in the literature.
Conservative treatment with follow up echocardiography for stable pulmonary balloon valvoplasty is recommended.
This is the most probable reason for not describing the complication in the previous echocardiography reports.At the recent presentation, fifteen years after valvuloplasty, the patient was still asymptomatic and had a systolic murmur on the upper left sternal border.The transthoracic echocardiography showed mild RV enlargement with normal function, mild to moderate residual PS (peak PG=46 mm Hg, mean PG=32 mm Hg), moderate PI, mild TR and RVSP~50 mm Hg.Annular size of pulmonic valve was 12 mm and standard echocardiographic evaluation showed mild residual valvular PS with mild pulmonary valve regurgitation.The patient was asymptomatic and serial follow up echocardiography showed no other complications.
It is worth mentioning that these presentations have been frequently reported on the base of pulmonary artery hypertension or aneurysm.