| Results of three to 10 year follow up of balloon dilatation of the pulmonary valve. | |
| | |
MedLine Citation:
|
PMID: 10065029 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The results of immediate and short term follow up of balloon dilatation of the pulmonary valve have been well documented, but there is limited information on long term follow up. OBJECTIVE: To evaluate the results of three to 10 year follow up of balloon dilatation of the pulmonary valve in children and adolescents. SETTING: Tertiary care centre/university hospital. DESIGN: Retrospective study. METHODS AND RESULTS: 85 patients (aged between 1 day and 20 years, mean (SD) 7.0 (6.4) years) underwent balloon dilatation of the pulmonary valve during an 11 year period ending August 1994. There was a resultant reduction in the peak to peak gradient from 87 (38) to 26 (22) mm Hg. Immediate surgical intervention was not required. Residual gradients of 29 (17) mm Hg were measured by catheterisation (n = 47) and echo Doppler (n = 82) at intermediate term follow up (two years). When individual results were scrutinised, nine of 82 patients had restenosis, defined as a peak gradient of 50 mm Hg or more. Seven of these patients underwent repeat balloon dilatation of the pulmonary valve: peak gradients were reduced from 89 (40) to 38 (20) mm Hg. Clinical evaluation and echo Doppler data of 80 patients showed that residual peak instantaneous Doppler gradients were 17 (15) mm Hg at long term follow up (three to 10 years, median seven), with evidence for late restenosis in one patient (1.3%). Surgical intervention was necessary to relieve fixed infundibular stenosis in three patients and supravalvar pulmonary stenosis in one. Repeat balloon dilatation was performed to relieve restenosis in two patients. Actuarial reintervention free rates at one, two, five, and 10 years were 94%, 89%, 88%, and 84%, respectively. Pulmonary valve regurgitation was noted in 70 of 80 patients at late follow up, but neither right ventricular dilatation nor paradoxical interventricular septal motion developed. CONCLUSIONS: The results of late follow up of balloon dilatation of the pulmonary valve are excellent. Repeat balloon dilatation was performed in 11% of patients and surgical intervention for subvalvlar or supravalvar stenosis in 5%. Most patients had mild residual pulmonary regurgitation but right ventricular volume overload was not required. Balloon dilatation is the treatment of choice in the management of moderate to severe stenosis of the pulmonary valve. Further follow up studies should be undertaken to evaluate the significance of residual pulmonary regurgitation. |
| | |
Authors:
|
P S Rao; O Galal; M Patnana; S H Buck; A D Wilson |
Related Documents
:
|
9535369 - Intracoronary embolization and retrieval of radio-opaque ring marker on the acs multi-l... 16286179 - Efficacy and safety of circumferential pulmonary vein isolation using a novel cryotherm... 11779019 - Temporary percutaneous aortic balloon occlusion to enhance fluid resuscitation prior to... 3439259 - Technology of current dilatation systems and methodological procedures. 16337059 - Percutaneous saphenectomy: a potentially dreadful complication of cutting balloon angio... 10885719 - Spontaneous transpyloric migration of a ballooned nasojejunal tube: a randomized contro... 21311859 - The safe establishment of a transseptal portal in the posterior knee. 19353439 - Middle cerebral artery flow after angioplasty and stenting of symptomatic internal caro... 10687159 - Scintigraphic evaluation of gastroesophageal reflux in newborns. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Heart (British Cardiac Society) Volume: 80 ISSN: 1355-6037 ISO Abbreviation: Heart Publication Date: 1998 Dec |
Date Detail:
|
Created Date: 1999-03-09 Completed Date: 1999-03-09 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 9602087 Medline TA: Heart Country: ENGLAND |
Other Details:
|
Languages: eng Pagination: 591-5 Citation Subset: AIM; IM |
Affiliation:
|
Division of Pediatric Cardiology, King Faisal Specialist Hospital, Riyadh, Saudi Arabia. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Balloon Dilatation* Child Child, Preschool Echocardiography, Doppler Female Follow-Up Studies Humans Infant Infant, Newborn Male Pulmonary Valve Stenosis / therapy* Recurrence Regression Analysis Statistics, Nonparametric Treatment Outcome |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Extent and severity of atherosclerotic involvement of the aortic valve and root in familial hypercho...
Next Document: Increased orthostatic tolerance following moderate exercise training in patients with unexplained sy...