Introduction: Pulmonary valve stenosis (PS) is a heart valve disorder in which outflow of blood from the right ventricle (RV) of the heart to the lungs is obstructed at the level of pulmonic valve. It is usually congenital and the prevalence of PS has been reported at 0.6 to 0.8 cases per 1000 live births. It can be due to isolated valvular (90%), subvalvular or supravalvular obstruction, or it may be associated with other congenital heart disorders. 1982 is the year when the technique of percutaneous balloon pulmonary valvuloplasty (BVP) was introduced and replaced surgical methods of treatment. (1, 2)

Case presentation: We present a case of 67-year-old man with congenital PS. He complained of occasional chest tightness and shortness of breath. There was Grade V/VI middle systolic crescendo-decrescendo murmur over the pulmonary area. Computed tomography, of the chest revealed marked enlargement of the left pulmonary artery (up to 43mm). Transthoracic echocardiography (TTE) revealed valvular PS (Vmax 5.66m/s) with RV wall hyperthropy (11-12mm) and transpulmonary pressure gradient (PG) was 128 mmHg. BPV was performed three days after admission. Initial hemodynamic measurement reported RV pressure of 140/0/12 mmHg and PA pressure 30/16/20 mmHg. After these measurements, balloon valvuloplasty was performed with subsequent decrease of RV pressure to 60/0/10 mmHg. At the follow up visit one year later the patient was asymtopmatic, and on TTE PG measured 51 mmHg with mild pulmonary regurgitation.

Conclusion: Balloon valvuloplasty is the treatment of choice in the management of moderate to severe PS in adults with good short and long-term results..