scholarly journals Balloon Angioplasty for Native Aortic Coarctation in 3- to 12-Month-Old Infants

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Juan Pablo Sandoval ◽  
Sok-Leng Kang ◽  
Kyong-Jin Lee ◽  
Lee Benson ◽  
Kentaro Asoh ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Balloon Angioplasty ◽  
Systolic Pressure ◽  
Coarctation Of The Aorta ◽  
Aortic Aneurysms ◽  
Older Children ◽  
Cross Sectional ◽  
Cross Sectional Imaging ◽  
Systolic Pressure Gradient ◽  
Lost To Follow Up

Background: Balloon angioplasty for native coarctation of the aorta (CoA) is successful in children and adults but in neonates results in frequent restenosis. The efficacy of balloon angioplasty for native CoA during infancy beyond the neonatal period was examined in infants aged 3 to 12 months of age. Methods: A retrospective review of 68 infants who underwent balloon angioplasty for native CoA. 95% CI are in parentheses. Results: Procedural age was (mean±SD) 6±3.4 months and weight was 7±1.8 kg. Balloon angioplasty produced a large decrease in both the noninvasive arm-to-leg blood pressure gradient (41.2±18.7 to 5.6±9.6 mm Hg) and the invasive peak systolic pressure gradient (34±12 to 11±9 mm Hg). Balloon angioplasty increased the CoA diameter from 2.7±1 mm to 4.6±1.2 mm. One patient was lost to follow-up. A catheter reintervention was required in 11.8% and surgery in 10.3%. The hazard of reintervention was highest early. Median freedom from reintervention was 89% (95% CI, 80%–96%) at 1 year, 83% (95% CI, 73%–92%) at 5 years, and 81% (95% CI, 69%–90%) at 10 years. Femoral artery thrombosis was documented in 6 (9%) infants without any long-term consequence. One patient developed a small aortic aneurysm late and has not required treatment. A robust estimate of the frequency of aortic aneurysms remains to be determined as the majority of subjects have not had cross-sectional imaging. Conclusions: Balloon angioplasty of native CoA is effective and safe in infants aged 3 to 12 months with outcomes comparable to those in older children and adults. Catheter reinterventions can avoid the need for surgery in most patients.

Systolic pressure gradients across the aortic valve and in the ascending aorta

1965 ◽  
Vol 209 (3) ◽  
pp. 557-563 ◽  
Author(s):  
Thomas E. Driscol ◽  
Richard W. Eckstein
Keyword(s):  
Aortic Valve ◽  
Pressure Gradient ◽  
Systolic Pressure ◽  
Left Ventricular Pressure ◽  
Aortic Pressure ◽  
Left Ventricular ◽  
Ventricular Pressure ◽  
Maximum Pressure ◽  
Early Systole ◽  
Systolic Pressure Gradient

Left ventricular and aortic pressure pulses and the pressure gradient across the aortic valve were recorded in anesthetized and unanesthetized dogs. Aortic pressure recorded immediately above the valve increased 5–15 msec before it was exceeded by left ventricular pressure. The maximum systolic pressure gradient occurred in early systole and remained positive throughout the ejection period. When aortic pressure was recorded 1–3 cm distal to the valve, these pressure pulse relationships were altered so that 1) the rise in aortic pressure was delayed, 2) the early systolic maximum pressure gradient was increased, and 3) aortic pressure exceeded ventricular pressure during the latter half of systole. The changes in early systole are due to a delay in the pulse wave reaching the more distal recording site. The mean systolic pressure gradient between two sites within the ascend-ing aorta was found to be negative, i.e., opposite to the direction of forward flow. The negative pressure gradient probably accounts for the reversal of the transvalvular pressure gradient in late systole when aortic pressure was recorded distal to the valve.

THE BRACHIAL TO DIGITAL BLOOD PRESSURE GRADIENT IN NORMAL SUBJECTS AND IN PATIENTS WITH HIGH BLOOD PRESSURE

1958 ◽  
Vol 36 (9) ◽  
pp. 889-893 ◽  
Author(s):  
P. Gaskell ◽  
A. M. Krisman
Keyword(s):  
Blood Pressure ◽  
Pressure Gradient ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Normal Subjects ◽  
Normal Blood ◽  
Control Group ◽  
Normal Blood Pressure ◽  
Hypertensive Patients ◽  
Systolic Pressure Gradient

The brachial and digital blood pressures were estimated by auscultatory techniques in 10 patients with essential hypertension and in a group of 6 subjects with normal blood pressure who were in a state of regulated peripheral vasoconstriction and again when they were in a state of regulated vasodilatation. The brachial to digital systolic and diastolic pressure gradients in both control subjects and hypertensive patients were greater when the individuals were heated than when they were cooled. The brachial to digital diastolic pressure gradient in the hypertensive patients was not significantly different from that in the subjects with normal blood pressure. However, the systolic pressure gradient was greater in the hypertensive patients than in the control group both when the individuals were heated and when they were cooled.

scholarly journals Stenosis of a Reconstructed Aorta Caused a Paradoxical Diastolic Pressure Gradient after Norwood Operation

2012 ◽  
Vol 6 ◽  
pp. CMC.S9789 ◽  
Author(s):  
Satoshi Masutani ◽  
Hirofumi Saiki ◽  
Hirotaka Ishido ◽  
Hideaki Senzaki
Keyword(s):  
Pressure Gradient ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Aortic Pressure ◽  
Ascending Aorta ◽  
Ventricular Ejection ◽  
Norwood Operation ◽  
Descending Aorta ◽  
The Difference ◽  
Systolic Pressure Gradient

An infant with hypoplastic left heart syndrome showed paroxysmal episodes of bradycardia, hypotension, and hypoxemia upon crying after modified Norwood operation. Echocardiography showed decreased right ventricular ejection with grade III tricuspid regurgitation, a markedly enlarged aortic arch, and accelerated blood flow distal to the enlarged aorta. Aortography demonstrated an aneurysmal neo-aorta with an apple-shaped appearance. The pressure measurements revealed intriguing aortic hemodynamics: the diastolic pressure of the ascending aorta was lower than that of the descending aorta (42 mmHg vs. 52 mmHg) despite no systolic pressure gradient. Markedly reduced compliance in the ascending aorta relative to that in the descending aorta, which was suggested by the difference in time constant of aortic pressure decay, may explain this hemodynamics. Impaired coronary circulation caused by lowered diastolic pressure in ascending aorta was indicated by reduced subendocardial viability ratio, and may account for her symptom and lowered ventricular ejection. The patient's condition was indeed significantly improved by surgical correction of the aortic shape. This case highlights the importance of aortic shape and properties after Norwood operation.

Electrocardiographic estimate of peak systolic pressure gradient in children with aortic stenosis

1985 ◽  
Vol 18 (3) ◽  
pp. 203-210
Author(s):  
Michael S. Shaffer ◽  
Rodney S. Fowler ◽  
Paul Corey ◽  
Cathy Steele ◽  
Michael L. Rigby ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Pressure Gradient ◽  
Systolic Pressure ◽  
Systolic Pressure Gradient

scholarly journals Balloon Pulmonary Valvuloplasty in patients with Congenital Valvular Pulmonary Stenosis

2013 ◽  
Vol 9 (1) ◽  
pp. 7-9 ◽  
Author(s):  
R Sharma ◽  
R Rajbhandari ◽  
Y Limbu ◽  
S Singh ◽  
YKD Bhatt ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Pressure Gradient ◽  
Pulmonary Valve ◽  
Pulmonary Stenosis ◽  
Systolic Pressure ◽  
Major Complication ◽  
Before And After ◽  
Single Balloon ◽  
Valvular Pulmonary Stenosis ◽  
Systolic Pressure Gradient

Background Congenital valvular pulmonary stenosis (PS) accounts for most of the etiology of PS, and constitutes about 5 to 10% of all congenital heart disease. Balloon Pulmonary Valvuloplasty has become the choice of treatment for valvular PS since the first series reported by Kan et al in 19824 and has almost replaced surgical valvotomy in pediatric patients. The purpose of this study was to investigate the immediate results of balloon valvuloplasty in patients with congenital valvular pulmonary stenosis. Method We analyzed hemodynamic data of 122 patients who underwent balloon pulmonary valvuloplasty (ages14days- 50 years mean 25 years). Single-balloon technique was used. Right ventricle systolic pressure and pulmonary valve Peak-to-peak systolic pressure gradient were recorded before and after balloon dilatation of pulmonary valve. Result Right ventricle systolic pressure decreased from 128±44.9 to 60±24.9 mmHg (p <0.001) and pulmonary valve peak-to-peak systolic pressure gradient decreased from 89±38.6 to 45 ± 22.4 mmHg (p <0.001). No major complication or mortality was noted. Conclusion Balloon pulmonary valvuloplasty is a safe and effective treatment for patients with congenital valvular PS. DOI: http://dx.doi.org/10.3126/njh.v9i1.8340 Nepalese Heart Journal Vol.9(1) 2012 pp.7-9ca

scholarly journals Evidence from cross-sectional imaging indicates abdominal but not thoracic aortic aneurysms are local manifestations of a systemic dilating diathesis

2009 ◽  
Vol 50 (1) ◽  
pp. 171-176.e1 ◽  
Author(s):  
Ian Nordon ◽  
Ranjeet Brar ◽  
Jeremy Taylor ◽  
Robert Hinchliffe ◽  
Ian M. Loftus ◽  
...  
Keyword(s):  
Aortic Aneurysms ◽  
Cross Sectional ◽  
Thoracic Aortic Aneurysms ◽  
Cross Sectional Imaging ◽  
Sectional Imaging
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