Document Detail


Further observations on the effect of balloon size on the short term and intermediate term results of balloon dilatation of the pulmonary valve.
MedLine Citation:
PMID:  3224054     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relation between the size of the balloon used for dilatation of the pulmonary valve and the extent of relief of pulmonary stenosis both immediately after and at intermediate term follow up was studied. Sixty four balloon dilatation procedures in 56 patients were divided into group 1-12 in which the ratio of the diameter of the balloon to that of the pulmonary annulus was less than or equal to 1.0--and group 2-52 in which the ratio was greater than 1.0. Both groups had similar mean (SD) pressure drops across the pulmonary valve before dilatation. Immediately after dilatation there was a significant reduction in the pulmonary valve gradient in both group 1 (84.3 (39.2) v 43.6 (26.8) mm Hg) and group 2 (92.8 (42.1) v 22.4 (13.6)mm Hg). On intermediate term follow up (6-34 months), residual pulmonary valve gradients were significantly lower in group 2 (20.8 (18.5)mm Hg) than in group 1 (75.0 (49.4) mm Hg), suggesting that restenosis was more common after dilatation with small balloons. These data suggest that although the immediate results with either small or large balloons are good, balloons that are larger than the pulmonary valve annulus produce more sustained relief of pulmonary stenosis. Further analysis within the group treated with larger balloons showed that the subgroup with a balloon/annulus ratio of 1.01-1.2 had more recurrences of stenosis (need for repeat balloon dilatation and larger number of patients with residual pulmonary valve gradients greater than 30 mm Hg) than subgroups with balloon/annulus ratios for diameters of 1.21-1.41, greater than 1.41, and greater than 1.5, in which there were no recurrences. Balloons that were > 1.5 times the size of the pulmonary valve annulus had no additional advantage over the other subgroups, namely, 1.21-- 1.4 and > 1.41. These results and reports of damage to the right ventricular outflow tract by oversized (> 1.5) balloons indicate that balloons that give a balloon/annulus ratio 1.2 -- 1.5 are the best for dilatation of the pulmonary valve.
Authors:
P S Rao
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  60     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1988 Dec 
Date Detail:
Created Date:  1989-03-27     Completed Date:  1989-03-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  507-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Balloon Dilatation / instrumentation*
Blood Pressure
Child
Child, Preschool
Follow-Up Studies
Humans
Infant
Infant, Newborn
Pulmonary Valve / pathology*,  physiopathology
Pulmonary Valve Stenosis / pathology,  physiopathology,  therapy*
Time Factors
Comments/Corrections

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