Document Detail


Balloon dilation of pulmonary valve stenosis in infants less than 3 kg: a 20-year experience.
MedLine Citation:
PMID:  19496127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study focused on the anatomical features and outcomes of percutaneous pulmonary valve balloon dilation (PVD) in newborns < or = 3 kg in weight. BACKGROUND: Although PVD is the treatment of choice for isolated pulmonary valve stenosis, there are no studies detailing technical, anatomical, and outcome variables in the smallest of infants undergoing the procedure. METHODS: A retrospective, consecutive review of all initial and follow-up echocardiograms, catheterization data, cineangiograms, and surgical records of all neonates less than 3 kg. RESULTS: Fifty infants underwent 55 PVD's, median age 7 days and weight 2.7 kg. Congestive heart failure and/or cyanosis were present in 55%, 46% prostaglandin dependent, with 28% having a hypoplastic right ventricle. The pulmonary valve diameter median z-score was -2.6, (range -5.8 to 1.2, P < 0.0001 vs. normal). The procedure was accomplished in all but one child, using a balloon to annulus ratio of 1.3 (range 1.1 to 1.7). There was a reduction in both the peak right ventricular systolic pressure (P < 0.0001) and outflow gradient (P < 0.0001). There was no procedure related mortality, although six children died in long-term follow-up (14%). Reintervention was necessary in 15 infants within 8 months of the procedure. Pulmonary regurgitation, present in 36% after the procedure, showed a gradual increase over time while outflow gradients decreased and valve annular dimensions increased toward normal. CONCLUSIONS: In infants < or = 3 kg, PVD is safe and effective. A large proportion remains free from surgery (76% at 10 years). Small valve annular dimensions show catch up growth with time.
Authors:
Tevfik Karagoz; Kentaro Asoh; Edward Hickey; Rajiv Chaturvedi; Kyong-Jin Lee; David Nykanen; Lee Benson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  74     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2010-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  753-61     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley-Liss, Inc.
Affiliation:
The Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8.
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple*
Balloon Dilatation* / adverse effects,  mortality
Birth Weight*
Cineangiography
Coronary Circulation
Echocardiography
Female
Heart Catheterization
Humans
Infant
Infant, Low Birth Weight
Infant, Newborn
Male
Pulmonary Valve Insufficiency / etiology
Pulmonary Valve Stenosis / diagnosis,  mortality,  physiopathology,  therapy*
Retrospective Studies
Severity of Illness Index
Survival Analysis
Time Factors
Treatment Outcome
Ventricular Pressure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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