Document Detail


Critical pulmonary stenosis.
MedLine Citation:
PMID:  12053395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Critical pulmonary stenosis causes cyanosis and can be potentially lethal in the neonate. Initial treatment includes general resuscitation and infusion of prostaglandin E1 to dilate the ductus. The diagnosis is usually made echocardiographically, but a right ventriculogram in the outflow tract may be necessary in some patients with only a tiny valve opening. Preformed catheters may aid in the passage of an appropriate guidewire. Valvuloplasty should be performed with a balloon approximately 1.2 times the annulus diameter. Most patients remain mildly to moderately cyanotic immediately after the procedure. With right ventricular (RV) growth and improved RV compliance, the cyanosis eventually resolves. Some patients may require prolonged prostaglandin infusion, a surgical shunt, or other mechanical means of maintaining systemic-to-pulmonary artery flow. Intermediate--to long-term results are excellent. However, only 5%-10% of patients may require surgical relief of residual valve or subvalvular stenosis. Very long-term follow-up raises concern about the significance of induced pulmonary insufficiency. Up to 30% of patients may require repeat balloon valvuloplasty.
Authors:
L A Latson
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  14     ISSN:  0896-4327     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2002-06-10     Completed Date:  2002-06-28     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  345-50     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiology, Center for Pediatric and Congenital Heart Diseases, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Balloon Dilatation / adverse effects
Critical Illness / therapy*
Follow-Up Studies
Humans
Pulmonary Valve Stenosis / diagnosis*,  therapy*
Treatment Outcome

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


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