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The purpose of this investigation was to evaluate the efficacy and follow-up results of balloon dilation angioplasty for valvular pulmonary stenosis. Percutaneous dilation was performed on 25 patients with pulmonary stenosis (aged 1 month to 69 years, mean = 15 years). In all cases, a single balloon was used. The pressure gradients across the pulmonary valve were estimated by continuous wave Doppler (CWD) and catheterization before and after dilation. The peak systolic gradients obtained by both techniques both pre- and post-angioplasty were compared. There was good linear correlation between the catheter pressure gradient and the pressure gradient estimated by Doppler (r = 0.78). The mean pre-angioplasty gradient of 82 +/- 33 mmHg (range 40-180) was reduced to 29 +/- 12 mmHg (range 17-50). The mean right ventricular systolic pressure of 110 +/- 33 mmHg decreased to 52 +/- 13 mmHg post-angioplasty. An excellent linear correlation was found between the pre-dilation gradient and the right ventricular systolic pressure drop (r = 0.94). During the procedures no complications were noted, 30 hours after dilation a 6 months old child suffered of stroke with transient hemiparesis. Follow-up pressure gradient estimations by Doppler echocardiogram were obtained in all patients between 3 months and 42 months (mean = 12.4 months); in 4 cases the catheterization was performed. Mean follow-up gradient was 33 +/- 11 mmHg (range 15-55). In a 18 months old child was detected a severe pulmonary restenosis 12 months after dilation; a second successful dilation was performed.(ABSTRACT TRUNCATED AT 250 WORDS)