scholarly journals Transcatheter perforation of atretic pulmonary valve by the stiff end of a coronary wire in neonates with pulmonary atresia with intact ventricular septum: A solution in developing countries

2018 ◽  
Vol 30 (3) ◽  
pp. 222-232 ◽  
Author(s):  
Sahar El Shedoudy ◽  
Eman El-Doklah
Keyword(s):  
Developing Countries ◽  
Pulmonary Valve ◽  
Pulmonary Atresia ◽  
Ventricular Septum ◽  
Intact Ventricular Septum

Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions

2012 ◽  
Vol 23 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Mazeni Alwi ◽  
Rahmat R. Budi ◽  
Marhisham Che Mood ◽  
Ming C. Leong ◽  
Hasri Samion
Keyword(s):  
Patent Ductus Arteriosus ◽  
Balloon Dilatation ◽  
Pulmonary Valve ◽  
Ductus Arteriosus ◽  
Pulmonary Atresia ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Total Occlusion ◽  
Patent Ductus

AbstractObjectiveTo determine the feasibility and safety of the Conquest Pro wire as an alternative to radiofrequency wire for perforation of atretic pulmonary valve and subsequent balloon dilatation and patent ductus arteriosus stenting in patients with pulmonary atresia with intact ventricular septum.BackgroundRadiofrequency valvotomy and balloon dilatation has become the standard of care for pulmonary atresia with intact ventricular septum in many institutions today.MethodsWe report eight consecutive patients in whom we used the Conquest Pro coronary guidewire, a stiff wire normally reserved for revascularisation of coronary lesions with chronic total occlusion, for perforation of atretic pulmonary valve and subsequent balloon dilatation, and stenting of the patent ductus arteriosus.ResultsPerforation of atretic pulmonary valve was successful in seven out of eight cases. Radiofrequency valvotomy was employed after failure of perforation by the Conquest Pro wire in one case where the right ventricular outflow tract was broad based and tapered towards the pulmonary valve, and was heavily trabeculated. Failure of the Conquest Pro wire to perforate the pulmonary valve plate was mainly attributed by the failure to engage the wire at the correct position.ConclusionThe Conquest Pro wire for perforation and subsequent interventions in the more straightforward cases of pulmonary atresia with intact ventricular septum is effective and safe, simplifying the entire procedure. However, the radiofrequency generator and wires remain essential tools in the paediatric interventional catheter laboratory.

scholarly journals Type I and Ii Pulmonary Atresia With Intact Ventricular Septum in Infants-10-year Experience in Initial Surgery at One Center

2021 ◽  
Author(s):  
Hailong Song ◽  
Ziying Chen
Keyword(s):  
Pulmonary Valve ◽  
Pulmonary Atresia ◽  
Ventricular Septum ◽  
Type I ◽  
Intact Ventricular Septum ◽  
Icu Stay ◽  
Initial Surgery ◽  
Operation Rate ◽  
Pda Ligation ◽  
Length Of Icu Stay

Abstract Background: To explore the effect of initial surgery for type I and II pulmonary atresia with intact ventricular septum (PA/IVS). Methods: Patients with type I and II PA/IVS undergoing initial surgery were enrolled, including type I with systemic to pulmonary (BT) shunt+patent ductus arteriosus (PDA) ligation+mosaic surgery (surgical A), BT shunt+PDA ligation+pulmonary valve incision without extracorporeal circulation (surgical B), type II with BT shunt+PDA ligation+right ventricular outflow tract (RVOT) incision+transpulmonary annulus patch (TP) (surgical C), and BT shunt+PDA ligation+RVOT incision+TP+artificial pulmonary valve (surgical D). Mechanical ventilation time (MVT), length of ICU stay, mortality rate, tricuspid Z value (TZ), tricuspid regurgitation (TR), McGoon ratio, oxygen saturation (SpO2), pulmonary transvalvular pressure (PTP), pulmonary regurgitation (PR), survival rate and re-operation rate were compared between surgical A and B, and between surgical C and D.Results: After surgery, PR was greater by surgical A than by surgical B at 1 month (P<0.05); lower TZ and McGoon ratio and greater PR, PTP and TR at 3 months (P<0.05); lower SpO2 (P<0.05), greater PTP at 6 months (P<0.01); greater TR and PTP at 1 year (P<0.05). MVT and length of ICU stay were longer by surgical C than by surgical D (P<0.05). There was greater PR at discharge and 1 month (P<0.01); greater TR and PR, lower McGoon ratio and SpO2 at 3 months (P<0.05); lower TZ and PTP and greater PR and PTP at 6 months (P<0.05) and 1 year (P<0.01) respectively.Conclusion: Surgical B and D are superior to surgical A and C respectively.

scholarly journals Transcatheter pulmonary valve perforation using chronic total occlusion wire in pulmonary atresia with intact ventricular septum

2017 ◽  
Vol 10 (1) ◽  
pp. 5 ◽  
Author(s):  
NageswaraRao Koneti ◽  
Shweta Bakhru ◽  
Shilpa Marathe ◽  
Manish Saxena ◽  
Sudeep Verma ◽  
...  
Keyword(s):  
Chronic Total Occlusion ◽  
Pulmonary Valve ◽  
Pulmonary Atresia ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Total Occlusion

scholarly journals Late Pulmonary Valve Replacement in Patients With Pulmonary Atresia and Intact Ventricular Septum: A Case-Matched Study

2011 ◽  
Vol 91 (2) ◽  
pp. 555-560 ◽  
Author(s):  
Victor Bautista-Hernandez ◽  
Babar S. Hasan ◽  
David M. Harrild ◽  
Ashwin Prakash ◽  
Diego Porras ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Atresia ◽  
Pulmonary Valve Replacement ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Matched Study

Are early palliative procedures providing an adequate long-term benefit in young cyanotic infants from developing countries, despite advances in surgery and interventions?

2020 ◽  
pp. 1-13
Author(s):  
Pramod Sagar ◽  
Kothandam Sivakumar ◽  
Koneru L. Umamaheshwar ◽  
Bhushan Sonawane ◽  
Asish R. Mohakud ◽  
...  
Keyword(s):  
Developing Countries ◽  
Right Ventricle ◽  
Pulmonary Atresia ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Septum ◽  
Intact Ventricular Septum ◽  
Technical Success ◽  
Long Term Outcome ◽  
Late Mortality

Abstract Objectives: Ductal stents, right ventricular outflow tract stents, and aortopulmonary shunts are used to palliate newborns and infants with reduced pulmonary blood flow. Current long-term outcomes of these palliations from resource-restricted countries are unknown. Methods: This single-centre, retrospective, observational study analysed the technical success, immediate and late mortality, re-interventions, and length of palliation in infants ≤5 kg who underwent aortopulmonary shunts, ductal, and pulmonary outflow stents. Patients were grouped by their anatomy. Results: There were 69 infants who underwent one of the palliations. Technical success was 90% for aortopulmonary shunts (n = 10), 91% for pulmonary outflow stents (n = 11) and 100% for ductal stents (n = 48). Early mortality within 30 days in 12/69 patients was observed in 20% after shunts, 9% after pulmonary outflow stents, and 19% after ductal stents. Late mortality in 11 patients was seen in 20% after shunts, 18% after outflow stents, and 15% after ductal stents. Seven patients needed re-interventions; two following shunts, one following outflow stent, and four following ductal stents for hypoxia. Among the anatomical groups, 10/12 patients with pulmonary atresia, intact ventricular septum survived after valvotomy and ductal stenting. Survival to Glenn shunt after ductal stent for pulmonary atresia, intact ventricular septum and diminutive right ventricle was very low in two out of eight patients, but very good (100%) for other univentricular hearts. Among 35 patients with biventricular lesions, 22 survived to the next stage. Conclusions: Cyanotic infants, despite undergoing technically successful palliation had a high inter-stage mortality irrespective of the type of palliation. Duct stenting in univentricular hearts and in pulmonary atresia with an intact ventricular septum and adequate sized right ventricle tended to have low mortality and better long-term outcome. Completion of biventricular repair after palliation was achieved only in 63% of patients, reflecting unique challenges in developing countries despite advances in intensive care and interventions.

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