Document Detail


Early results of balloon dilatation of the stenotic bovine jugular vein graft in the right ventricular outflow tract in children.
MedLine Citation:
PMID:  18341521     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to evaluate the early results of interventional balloon dilatation of stenotic bovine jugular vein (BJV) grafts implanted for reconstruction of the right ventricular outflow tract (RVOT) in children. METHODS: From May 2001 to December 2005, 153 BJV grafts were implanted in children in our institution. An average of 16.9 (7.6-41.1) months after implantation, 17 balloon dilatations in a significant stenosis proximal (n = 1), distal anastomosis (n = 8), BJV valve (n = 3), or at multiple sites (n = 5) were performed in 15 children (male:female = 9:6) with a mean age of 3.9 (0.8-13.0) years. Balloon diameter was 75-133.3% (mean 100.3) of the original BJV size. Mean follow-up was 8.8 (2 days to 22.8 months) months. RESULTS: In 10 interventions (58.8%) the instantaneous peak gradient was reduced below 50 mmHg. A balloon diameter > or =100% of the original BJV size correlated significantly with a successful intervention. No major complications, two minor (nonobstructive floating membranes at the dilatation site and one septicemia) occurred afterward. Freedom from reintervention after 6 months was 58.2% for all, 77.8% for dilatations of the proximal anastomosis and mixed stenotic lesions, and 33.3% for the distal anastomosis. CONCLUSION: Balloon dilatation of stenotic BJV grafts is safe and can significantly reduce the pressure gradient in two-thirds of interventions. Balloon diameters above the original graft size should be aimed for. The most frequent stenosis of the distal anastomosis tends to renarrow early after dilatation. Nevertheless, balloon dilatation should be considered in nearly every stenotic graft to gain time until a surgical or interventional graft exchange.
Authors:
J Steinberg; H Dave; W Knirsch; R Prêtre; M Weiss; P Harpes; O Kretschmar
Publication Detail:
Type:  Journal Article     Date:  2008-03-13
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  21     ISSN:  0896-4327     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-20     Completed Date:  2008-08-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  265-72     Citation Subset:  IM    
Affiliation:
Division of Pediatric Cardiology, University Children's Hospital Zurich, Steinwiesstrasse 75, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Balloon Dilatation*
Child
Child, Preschool
Coronary Angiography
Echocardiography
Female
Graft Occlusion, Vascular / diagnosis,  etiology*,  therapy*
Heart Catheterization / instrumentation
Humans
Infant
Infant, Newborn
Jugular Veins / transplantation*
Male
Middle Aged
Transplantation, Heterologous / adverse effects*
Treatment Outcome
Ventricular Outflow Obstruction / diagnosis,  etiology,  surgery

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


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