Modified technique for balloon valvuloplasty of critical pulmonary stenosis in the newborn

AbstractObjective:To assess the feasibility, safety, and efficiency of ductal stenting in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis after balloon pulmonary valvuloplasty.Background:Ductal stenting in pulmonary atresia with intact ventricular septum is a re-emerging and promising technique. There is little data available on its outcomes after establishing prograde pulmonary blood flow.Methods:We retrospectively reviewed all neonates with pulmonary atresia with intact ventricular septum or critical pulmonary stenosis who underwent ductal stenting after balloon valvuloplasty. Ductal stenting was performed either in the same setting (group A) or a few days later after balloon valvuloplasty (group B). We compared the two groups.Results:Eighteen coronary stents were transvenously delivered and successfully deployed in 18 newborns. There was no procedure-related mortality. The median hospital stay post-intervention was 6 days with a mean discharge oxygen saturation of 94%. Group A had a shorter overall hospital stay with a shorter overall time of irradiation but with a longer overall procedural time. On a follow-up of 18 months, no re-intervention for stent failure or overflow was undertaken. The median stent patency based on echocardiography was 12 months.Conclusion:Stenting the arterial duct in pulmonary atresia with intact ventricular septum or critical pulmonary stenosis is a feasible, safe, and efficient technique. It avoids surgery or long hospital stay with prostaglandin infusion. The minimal 6 months stent longevity provides a period of time long enough to decide whether the right ventricular diastolic function is normalised or Glenn surgery is still needed.

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Transcatheter pulmonary balloon valvuloplasty of severe valvar pulmonary stenosis and atrial septal defect in patient with severe cyanosis and very low ventricle ejection fractions: a bailout procedure

Cardiology in the Young ◽

10.1017/s1047951121001967 ◽

2021 ◽

pp. 1-3

Author(s):

Sisca N. Siagian ◽

Nikolaus A. Haas ◽

Radityo Prakoso

Keyword(s):

Ejection Fraction ◽

Atrial Septal Defect ◽

Septal Defect ◽

Pulmonary Stenosis ◽

Balloon Valvuloplasty ◽

Defect Closure ◽

Atrial Septal Defect Closure ◽

Interventional Management ◽

Critical Pulmonary Stenosis ◽

Valvar Pulmonary Stenosis

Abstract Most cases of severe or critical pulmonary stenosis are detected early and interventional management is routine within the first days of life. We present a case of a thirteen-year-old boy diagnosed with pulmonary stenosis and atrial septal defect with low ventricle ejection fraction. The patient underwent staged pulmonary balloon valvuloplasty and interventional atrial septal defect closure with good results.

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English Case report: Succesfully Management of Critical Pulmonary Stenosis in a 12-Month-Old Boy By percutaneous transluminal balloon valvuloplasty

WMJ (Warmadewa Medical Journal) ◽

10.22225/wmj.6.2.3356.67-74 ◽

2021 ◽

Vol 6 (2) ◽

pp. 67-74

Author(s):

Dyahris Koentartiwi

Keyword(s):

Oxygen Saturation ◽

Septal Defect ◽

Pulmonary Valve ◽

Ductus Arteriosus ◽

Pulmonary Stenosis ◽

Balloon Valvuloplasty ◽

Limited Resources ◽

Percutaneous Transluminal ◽

Critical Pulmonary Stenosis ◽

Patent Ductus

Abstract Critical pulmonary stenosis (PS) is used in infants born with very severe narrowing valves and requires treatment soon after birth. At four months old, an A-12-month-old boy was diagnosed with critical pulmonary stenosis but still successfully managed by percutaneous transluminal balloon valvuloplasty (PTBV) with satisfactory results without serious complications. Since he was born, cyanosis was seen at his lips and fingertip, with oxygen saturation around 60% until 70%. Echocardiography showed critical pulmonary stenosis, atrial septal defect (ASD), and patent ductus arteriosus (PDA). Percutaneous transluminal balloon valvuloplasty (PTBV) is accepted as the treatment of choice for critical pulmonary valve stenosis in many centers worldwide with significant results. After PTBV, he experienced improvement condition as no cyanosis was observed and oxygen saturation was 96%. This case was our first PTBV intervention case in our hospital and gave satisfactory results, although the intervention was delayed due to our limited resources before. Keywords: cyanosis, critical pulmonary stenosis, percutaneous transluminal balloon valvuloplasty

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