Wall pressure spectra scaling downstream of stenoses in steady tube flow.
Explore the source record for details and available documents.
SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Percutaneous balloon valvuloplasty is a technique that has been developed in the cardiac catheterization laboratory over the last 5 years for the treatment of pulmonic, mitral and aortic valve stenosis in children and adults. This review will attempt to summarize recent advances in this new field of invasive cardiology over the last several years.
Explore the source record for details and available documents.
In the technique of percutaneous balloon valvuloplasty, one or more large balloons are inserted percutaneously and then inflated across a stenotic valve to decrease the degree of obstruction. Currently, the procedure is being performed for patients with pulmonic, mitral, or aortic stenosis. The results vary according to the type of valve and the age of the patient. In patients with pulmonic stenosis, balloon valvuloplasty can be performed safely and the results are excellent. Therefore, at many institutions it is the procedure of choice for the treatment of isolated pulmonic stenosis. In patients with mitral stenosis, the results depend on the morphologic features of the stenotic valve. In patients with highly calcified and fibrotic mitral valve leaflets, the risks of the procedure are increased and the results are suboptimal. In experienced hands, however, balloon valvuloplasty is excellent for patients with a pliable, noncalcified mitral valve or those for whom operation imposes an extremely high risk. The use of balloon valvuloplasty for aortic stenosis has been limited to the frail, elderly patient who either is not a surgical candidate or is at high risk for operation. Although mortality and restenosis rates are high on short-term follow-up, aortic balloon valvuloplasty provides palliation of symptoms in many patients who otherwise would have been unable to undergo any intervention. Long-term follow-up is necessary for determining the ultimate role of balloon valvuloplasty in cardiology.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Over the last five years, percutaneous balloon dilatation has been developed as a nonsurgical treatment of stenotic cardiac valves in children and adults. In this paper, we review the state of the art in this new and evolving field of interventional cardiac catheterization.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A comparison of several reported methods for detection and quantitation of left-to-right shunts by radionuclides was performed in 50 children. Count ratio (C2/C1) techniques were compared with the exponential extrapolation and gamma function area ratio techniques. C2/C1 ratios accurately detected shunts and could reliably separate shunts from normals, but there was a high rate of false positives in children with valvular heart disease. The area ratio methods provided more accurate shunt quantitation and a better separation of patients with valvular heart disease than did the C2/C1 ratio. The gamma function method showed a higher correlation with oximetry than the exponential method, but the difference was not statistically significant. For accurate shunt quantitation and a reliable separation of patients with valvular heart disease from those with shunts, area ratio calculations are preferable to the C2/C1 ratio.
The child with significant valvular heart disease may present in any single instance both the most difficult of management decisions or a surprisingly simple one. Thus, if a direct surgical approach on the valve is feasible, the problems may very well be quite simple and straightforward; conversely, if valve replacement is indicated such may not be the case. We have recently reported our experience with one type of valvular heart condition, congenital aortic stenosis, in respect to determination of surgical approach based upon the ability to predict the orifice area and valvular anatomy. This report reviews our current experience with this technique. As well, the experience concerning the approach to each of the valvular conditions will also be reviewed with emphasis in respect to the left heart valves and particularly their long term postoperative management.