| Early and late results and the effects on pulmonary arteries of balloon dilatation of the right ventricular outflow tract in tetralogy of Fallot. | |
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MedLine Citation:
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PMID: 9597408 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Balloon dilatation of the pulmonary valve remains controversial as a palliative procedure in tetralogy of Fallot. AIMS: To determine the clinical outcome, growth of the pulmonary vascular tree and findings at surgery of balloon dilatation of the pulmonary valve performed as a palliation in infants with tetralogy of Fallot. METHODS AND RESULTS: Thirty-three severely cyanosed infants (mean age of 3 months for the whole population, including seven neonates) underwent this procedure from June 1990 to January 1997. After balloon dilatation, systemic oxygen saturation increased from a mean value of 76 +/- 9% to 88 +/- 7% (P < 0.001). The procedure was accomplished without complications. Four patients had recurrent hypoxic spells after dilatation leading to surgical repair within 30 days of dilatation (three modified Blalock-Taussig shunts and one complete repair). A control study was performed at a mean of 6.1 +/- 4.5 months after dilatation in 16 patients to establish growth of the pulmonary vascular tree (repeat catheterization in nine patients and surgical pulmonary annulus calibration in seven). The pulmonary annulus increased from a mean Z score of -4.1 +/- 0.9 SD to -2.5 +/- 1.1 SD (P < 0.001). Z score for the right pulmonary artery from -3.0 +/- 0.6 SD to -1.9 +/- 1.2 SD (P = 0.007) and the Z score for the left pulmonary artery from -2.7 +/- 0.7 SD to -1.6 +/- 1.3 SD (P = 0.021). At late follow-up (mean of 9 months after dilatation, range 3 to 54 months), 28 patients underwent complete repair. Trans-annular patching was required in 43% of patients. Four post-operative deaths were observed, none dilatation related. CONCLUSION: Balloon dilatation of the pulmonary valve is an effective and safe palliation in tetralogy of Fallot. It promotes growth of the pulmonary vascular tree, reducing the need for trans-annular patching and is recommended in symptomatic infants of very young age, with a small pulmonary annulus (Z value below -4 SD) and associated cardiac anomaly. |
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Authors:
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F Godart; C Rey; A Prat; C Muilwijk; C Francart; G Vaksmann; G M Brevière |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: European heart journal Volume: 19 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 1998 Apr |
Date Detail:
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Created Date: 1998-07-22 Completed Date: 1998-07-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 595-600 Citation Subset: IM |
Affiliation:
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Service de Cardiologie Infantile, Hôpital Cardiologique, CHRU de Lille, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Balloon Dilatation* Blood Flow Velocity Female Follow-Up Studies Heart Catheterization Humans Infant Linear Models Male Prognosis Pulmonary Artery / physiopathology Pulmonary Valve / physiopathology* Retrospective Studies Tetralogy of Fallot / diagnosis, physiopathology, therapy* Treatment Outcome Ventricular Function, Right* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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