scholarly journals Outcomes of percutaneous balloon pulmonary valvuloplasty in congenital pulmonary valve stenosis

2021 ◽  
Vol 9 (9) ◽  
Author(s):  
Dan Yin ◽  
Xiaoyun Wu ◽  
Ping Xiang ◽  
Yu Zhang ◽  
Jie Tian ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Pulmonary Valve Stenosis ◽  
Percutaneous Balloon

Angiographic features associated with percutaneous balloon valvotomy for pulmonary valve stenosis

1988 ◽  
Vol 11 (2) ◽  
pp. 111-116 ◽  
Author(s):  
Patricia E. Burrows ◽  
Lee N. Benson ◽  
Jeffrey S. Smallhorn ◽  
C. A. Frederic Moes ◽  
Robert M. Freedom ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Pulmonary Valve Stenosis ◽  
Percutaneous Balloon ◽  
Balloon Valvotomy

Long-term results of percutaneous balloon valvuloplasty in neonatal critical pulmonary valve stenosis: a 20-year, single-centre experience

2017 ◽  
Vol 27 (7) ◽  
pp. 1314-1322
Author(s):  
Petra Loureiro ◽  
Barbara Cardoso ◽  
Inês B. Gomes ◽  
José F. Martins ◽  
Fátima F. Pinto
Keyword(s):  
Pulmonary Valve ◽  
Pressure Ratio ◽  
Balloon Valvuloplasty ◽  
Long Term Results ◽  
Pulmonary Valve Stenosis ◽  
Single Centre ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Valvuloplasty

AbstractIntroductionPercutaneous balloon valvuloplasty is the primary treatment for critical pulmonary valve stenosis in neonates. Thus far, a few studies have reported long-term results of this technique in neonatal critical pulmonary valve stenosis.MethodsWe carried out a retrospective study of all consecutive newborns with critical pulmonary valve stenosis subjected to percutaneous balloon valvuloplasty at a single centre, between 1994 and 2014, to assess its immediate and long-term safety and efficacy.ResultsA total of 24 neonates presented with critical pulmonary valve stenosis. The mean diameter of the pulmonary annulus was 7 mm (±1.19); 33.3% had a dysplastic pulmonary valve, and 92% were started on prostaglandin E1 treatment. Percutaneous balloon valvuloplasty was performed at a mean age of 4.0±4.3 days using, on average, a balloon-to-pulmonary annulus ratio of 1.18 mm (with a range from 0.9 to 1.43). Immediate success was achieved in 22/24 patients (92%) with a reduction in the pulmonary transvalvular peak gradient (p<0.05) and in the right ventricle/systemic pressure ratio (p<0.05). There was one death (4%) 6 days after the procedure, and 29.2% of them had transient rhythm complications. For a mean follow-up time of 8.4 years, the re-intervention rate was 42.9%. In total, 14 re-interventions were performed in nine neonates, including surgery in six. Freedom from re-intervention was 50% at 8 years and 43% at 10 and 15 years.ConclusionThis series, to the best of our knowledge, has had the longest follow-up of neonates with critical pulmonary valve stenosis. Percutaneous balloon valvuloplasty is a safe and effective treatment, and in our study 75% of the patients were exclusively treated using this technique.

Percutaneous Balloon Valvuloplasty: A New Method for Treating Congenital Pulmonary-Valve Stenosis

1982 ◽  
Vol 307 (9) ◽  
pp. 540-542 ◽  
Author(s):  
Jean S. Kan ◽  
Robert I. White ◽  
Sally E. Mitchell ◽  
Timothy J. Gardner
Keyword(s):  
Pulmonary Valve ◽  
New Method ◽  
Balloon Valvuloplasty ◽  
Pulmonary Valve Stenosis ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Valvuloplasty

scholarly journals Percutaneous balloon valvuloplasty for pulmonary valve stenosis in infants and children.

Heart ◽  
1985 ◽  
Vol 54 (4) ◽  
pp. 435-441 ◽  
Author(s):  
I D Sullivan ◽  
P J Robinson ◽  
F J Macartney ◽  
J F Taylor ◽  
P G Rees ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Infants And Children ◽  
Balloon Valvuloplasty ◽  
Pulmonary Valve Stenosis ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Valvuloplasty ◽  
In Infants And Children

scholarly journals 336 Right ventricular mechanics in patients affected by pulmonary valve stenosis, before and after percutaneous pulmonary angioplasty

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Domenico Sirico ◽  
Giulia Spigariol ◽  
Alessia Basso ◽  
Elena Reffo ◽  
Roberta Biffanti ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Pressure Gradient ◽  
Right Ventricular ◽  
Pulmonary Valve ◽  
Systolic Function ◽  
Balloon Valvuloplasty ◽  
Pulmonary Valve Stenosis ◽  
Ventricular Mechanics ◽  
Percutaneous Balloon ◽  
Before And After

Abstract Aims Pulmonary valve stenosis accounts for 6–9% of all congenital heart diseases. The main effect of this obstructive lesion is a rise in right ventricular pressure; this overload leads to multiple changes in shape, dimensions, and volume of the ventricle. The diagnosis is based on transthoracic echocardiography and invasive heart catheterization. Usually the stenosis is classified into mild, moderate, and severe based on pressure gradient between right ventricle and pulmonary artery and on the ratio between right ventricle and left ventricle systolic pressure. Percutaneous balloon valvuloplasty is the treatment of choice in severe pulmonary valve stenosis in patients of all ages; alternatively surgical valvotomy is an option in selected cases. The aim of this study is to evaluate the mechanical changes of the right ventricle in patients undergoing balloon pulmonary valvuloplasty using transthoracic and speckle-tracking echocardiography (STE). Furthermore, we sought to investigate the correlation between haemodynamic and echocardiographic parameters to better evaluate the degree of pulmonary valve stenosis before and after treatment. Methods and results Forty-three pediatric patients (19 males), mean age 3.2 ± 4.9 years with severe pulmonary valve stenosis and indication for percutaneous balloon valvuloplasty were recruited at the University Hospital of Padua. All patients underwent standard transthoracic echocardiography (TTE), STE with analysis of right ventricle global longitudinal strain (RVGLS) one day before and one day after the procedure. For each patient were collected invasive parameters during the interventional procedure before and after balloon valvuloplasty. After the procedure, there was an immediate statistically significant reduction of both peak-to-peak transpulmonary gradient (Dp post) and ratio between the systolic pressure of right and left ventricle (RV/LV ratio) with a drop of 29.3 ± 14.67 mmHg and 0.43 ± 0.03, respectively. Post-procedural echocardiography showed peak and mean transvalvar pressure gradient drop (50 ± 32.23 and 31 ± 17.97, respectively). The degree of pulmonary valve regurgitation was mild in 8% of patients before the procedure, following the intervention it reached 29% with a statistically significant increase (P = 0.007). However, the incidence of pulmonary valve moderate and severe regurgitation remained stable after the procedure. The analysis of right ventricular function and mechanics showed a significant improvement of Fractional Area Change (FAC) immediately after the procedure (40.11% vs. 44.42%, P = 0,01). On the other hand, right ventricular longitudinal systolic function parameters, TAPSE (P = 0.60) and longitudinal strain (P = 0.31), did not improve significantly after intervention. Finally, pre-procedural invasive RV/LV ratio showed good correlation to echocardiographic transvalvular peak and mean pressure gradient (R = 0.375, P = 0.019 and R = 0.40, P = 0.012, respectively), as well as with FAC (R = 0.31, P = 0.05), TAPSE (R = 0.62, P &lt; 0.001), and RVGLS (R = 0.46, P = 0.01). Conclusions Percutaneous balloon pulmonary valvuloplasty represents an efficient and safe procedure to relieve severe pulmonary valve stenosis. Interestingly, the analysis of right ventricular mechanics on echocardiography demonstrated an immediate global systolic function improvement following afterload reduction. Conversely, longitudinal systolic function did not show improvement immediately after intervention, possibly due to the necessity of longer time to recover. Finally, invasive preprocedural RV/LV ratio demonstrated better correlation with echocardiographic evaluation of stenosis degree and right ventricular function compared to invasive peak-to-peak pressure gradient. Therefore, RV/LV ratio should be preferred for the assessment of pulmonary valve stenosis.

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