Objective:

To provide consistent data on the long-term outcomes of BPV and identify risk factors for restenosis/reintervention and pulmonary insufficiency following BPV.

Approach:

• Search Strategy: A systematic literature review was conducted following PRISMA guidelines, searching Medline, Scopus, Web of Science, and Cochrane databases for articles published from January 1995 to October 2025.
• Eligibility Criteria: Studies were included if they involved pediatric patients with isolated pulmonary valve stenosis treated with BPV and had a mean or median follow-up duration of at least 5 years.
• Data Collection: Data were extracted independently and verified for accuracy, focusing on primary outcomes of restenosis and clinically significant pulmonary insufficiency.

Key Findings:

• BPV has shown a sustained reduction in the peak-to-peak gradient across the pulmonary valve.
• Restenosis occurs in a small minority of patients during mid-term follow-up.
• Long-term outcomes remain unclear, with limited consistent data available.

Interpretation:

Pulmonary valve restenosis and moderate to severe pulmonary insufficiency are the predominant late complications of BPV.

Limitations:

• Limited long-term data on outcomes following BPV.
• Heterogeneity in stenosis severity metrics and outcome definitions across studies.

Conclusion:

This review aims to provide consistent data on the long-term outcomes of BPV and identify risk factors for restenosis/reintervention and pulmonary insufficiency.