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Results for “PULMONARY VALVE STENOSIS”

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At least 37 records · Page 2Linked to original sources
PubMed1975

[Hemodynamic aspect of infundibular hypertrophy of pulmonary valve stenosis].

Reactional infundibular hypertrophy in pulmonary valve stenosis is usually assessed on the catheterization curves obtained in the infundibulum and in the inflow tract of the right ventricle. It is usually indicated by a peculiar pattern of the infundibular curve: its descending branch is more rapid than in the inflow tract and is slightly curvilinear. This deformity is the more marked the more intense the hypertrophy. Simultaneously a mid-late systolic murmur is recorded into the infundibulum the more intense and high-pitched the more marked the hypertrophy. Comparison with the angiocardiographic data and the operative findings showed a good correlation.

Angiocardiography↗
PubMed1992

Intermediate-term results of balloon valvuloplasty for isolated and complicated pulmonary valve stenosis.

UNLABELLED: The purpose of this study is to report our experience regarding the acute and intermediate-term results of balloon pulmonary valvuloplasty (BPV) in various types of congenital pulmonary valve stenosis. METHODS AND RESULTS: Twenty-four consecutive patients with a median age of 6.6 years (ranging from 1 month to 24 years old) underwent BPV between January 1988 and September 1991. These patients were divided into 2 groups; Group 1 consisting of 13 patients with isolated pulmonary valve stenosis, and Group 2 consisting of 11 patients with complicated pulmonary valve stenosis (supravalvular, subvalvular, valved conduit and post-right ventricular outflow reconstruction). Mean peak systolic pressure gradients from the right ventricle to the pulmonary artery were as follows: In group 1, 48 +/- 21 (mean +/- SD) mmHg before BPV, 18 +/- 8 mmHg immediately after BPV and 13 +/- 5 mmHg at the longest follow-up based on catheterization or Doppler echocardiographic studies. The gradients in group 2 were 65 +/- 28 mmHg before BPV, 46 +/- 25 mmHg immediately after BPV and 47 +/- 21 mmHg at the longest follow-up. CONCLUSIONS: BPV provides both acute and intermediate-term gradient relief in patients with isolated pulmonary valve stenosis. In complicated pulmonary valve stenosis, on the other hand, the effect of BPV was unsatisfactory and appears to depend on the mechanism of associated obstruction. Therefore accurate evaluation of the anatomy of associated obstruction in the pulmonary valve region is needed to determine that BPV is indicated.

Adolescent↗
PubMed1988

Hour-glass deformity of the pulmonary valve: a third type of pulmonary valve stenosis.

In the 12 years from 1975 to 1987, 55 patients had open pulmonary valve surgery for isolated congenital stenosis of the pulmonary valve. Three types of pulmonary stenosis were seen: (a) dome-shaped pulmonary stenosis (34 patients); (b) dysplastic pulmonary valves with thick cauliflower-like cusps (12 patients), and (c) hour-glass deformity of the pulmonary valve, with "bottle-shaped" sinuses (nine patients). This third type has not been described before. Preoperative identification of the valve structure is important because the choice of treatment (balloon dilatation for some dome-shaped valves and excision for dysplastic and hour-glass valves) depends on the type of stenosis.

Adolescent↗
PubMed1984

Percutaneous transluminal balloon valvuloplasty for pulmonary valve stenosis.

Transluminal balloon valvuloplasty was used to treat congenital pulmonary valve stenosis in 20 patients. Follow-up cardiac catheterization was performed in 11 patients at intervals of from 2 to 12 months after the procedure. Peak systolic pressure gradient across the pulmonic valve decreased from 68 +/- 27 to 23 +/- 5 mm Hg (p less than .001) after valvuloplasty. There were no complications. Follow-up catheterization demonstrated persistent relief of right ventricular hypertension in the patients with typical pulmonary valve stenosis.

Adolescent↗
PubMed1990

Percutaneous balloon pulmonic valvuloplasty following treated endocarditis in a patient with congenital pulmonary valve stenosis.

A 36-year-old woman with congenital pulmonary valve stenosis developed the rare complication of endocarditis of the valve. After successful sterilization of the valve, the patient underwent percutaneous balloon pulmonic valvuloplasty at a later date. The procedure successfully reduced the peak pulmonary valve gradient from 94 to 45 mm Hg. Percutaneous balloon valvuloplasty is the procedure of choice for treatment of congenital pulmonary valvular stenosis, even in the unusual patient who has healed endocarditis of the pulmonary valve.

Adult↗
PubMed1988

[Results of balloon valvuloplasty in pulmonary valve stenosis].

Percutaneous balloon pulmonary valvuloplasty was performed in 17 consecutive patients, ranging in age from eleven years to 67 years (mean age: 40 +/- 17 years). The peak to peak pressure gradient was reduced by 16 to 167 mm Hg, the mean pressure gradient decreased from 99 +/- 42 to 46 +/- 22 mm Hg. In six patients there was a pressure gradient above 50 mm Hg after the procedure. Within three months it decreased due to regression of infundibular hypertrophy and ranged from 26 to 46 mm Hg after one year. There were no serious complications. One patient experienced a brief episode of syncope. Another patient developed a pulmonary incompetence which was without hemodynamic significance. Percutaneous balloon pulmonary valvuloplasty offers an alternative method for treating pulmonary stenosis not only in children but also in adults.

Adolescent↗
PubMed1996

Treatment of critical pulmonary valve stenosis by balloon dilatation in the neonate.

Critical pulmonary valve stenosis represents an emergency, and immediate treatment is mandatory. The purpose of this study was to evaluate the immediate and medium-term results of pulmonary valve dilatation. We report 18 neonates in whom pulmonary valvuloplasty was attempted. The procedure could be accomplished in 14 patients. The angiographically determined diameters of the pulmonary and tricuspid valve at the time of procedure were 5.6 +/- 1.5 mm and 14.0 +/- 5.4 mm. The mean Doppler gradient decreased from 71 +/- 27 mm Hg to 27 +/- 14 mm Hg. Perforation of the right ventricular outflow tract was the major complication in three patients with one fatal event. Infusion of prostaglandin E1 could be discontinued 1 to 5 days after the procedure. On follow-up three children required a second balloon dilatation with good results. Seven patients monitored for more than 9 months with a mean follow-up time of 34.4 +/- 16 months had a residual gradient of 11.6 +/- 6.7 mm Hg. In spite of a hypoplastic pulmonary valve annulus in seven of the patients, results were good and surgery could be avoided.

Catheterization↗
PubMed2006

Alpha(2)-blocker helps to avoid systemic to pulmonary shunt in a prostaglandin dependent infant with critical pulmonary valve stenosis.

A 27 days old newborn with critical pulmonary valve stenosis remained prostaglandin (PGE(1)) dependent for 2 weeks after successful balloon valvuloplasty. Only the introduction of Phentolamine in his medication regimen, allowed PGE(1) to be weaned off within days of this therapy. The medication was continued for 4 days and replaced by angiotensin converting enzyme inhibitor (Captopril). Few weeks after the discharge, the patient remained clinically stable with acceptable saturation.

Adrenergic alpha-Antagonists↗
PubMed1988

[The treatment of pulmonary valve stenosis using balloon dilatation. Long-term results].

Percutaneous pulmonary valvuloplasty has been used successfully in the treatment of pulmonary valve stenosis for several years, but reports on long-term results are still sparse. We have performed pulmonary valve balloon dilatation procedures 23 times in 22 patients since February 1985; the age of the patients ranged from 2 days to 22 years. Three patients did not benefit from the procedure, in two instances because the pulmonary valve was dysplastic and once because of severe associated infundibular stenosis. These patients subsequently underwent surgery. In the other 19 patients the initial transvalvular gradient of 35 to 160 mm Hg (mean 81 mm Hg) was markedly reduced (to values ranging from 10 to 60 mm Hg, mean 31 mm Hg) rendering surgery unnecessary. There were no complications. The patients have been followed up for periods ranging from 2 months to 3 years and all are asymptomatic. Repeat measurements of the transvalvular gradient were carried out either by recatheterization or by echo Doppler 4 months to 3 years after the procedure; we have not observed restenosis and the mean gradient remained unchanged compared to the measurements immediately after valvuloplasty. Pulmonary regurgitation was uncommon and indeed appears to be less prominent than after surgical valvotomy. Thus, percutaneous valvuloplasty now appears to be the preferred treatment for pulmonary valve stenosis and open heart surgery can be avoided in most cases.

Adolescent↗
PubMed1976

Long-term results of surgical treatment for pulmonary valve stenosis.

109 children who survived surgical treatment for isolated pulmonary valve stenosis were followed for up to 17 years. In all the postoperative status was assessed as satisfactory. Cardiac catheterization repeated in 43 gave a resting valve gradient below 40 mmHg. The 22 children whose pulmonary valves had been excised were as healthy as the 87 who had undergone pulmonary valvotomy. Consideration was given to the desirable length of postoperative review. Except for the few children with symptoms before operation, a postoperative increase in exercise tolerance was not a feature.

Adolescent↗
PubMed2003

Comparative long-term results of surgery versus balloon valvuloplasty for pulmonary valve stenosis in infants and children.

BACKGROUND: We compared the long-term results of surgical valvotomy (S) versus balloon valvuloplasty (BV) for pulmonary valve stenosis in infants and children. METHODS: Results after surgical pulmonary valvotomy (with concomitant ASD/VSD closure) (n = 62, age 2.9 +/- 3.5 years) and balloon valvuloplasty (n = 108, age 3.6 +/- 3.9 years) were analyzed. Transvalvular mean pressure gradient decrease, freedom from reintervention for restenosis, pulmonary valve insufficiency, and tricuspid valve insufficiency were considered. RESULTS: Mean pressure gradient decreased significantly more in the surgical group (from 64.8 +/- 30.8 mm Hg to 12.8 +/- 9.8 mm Hg at a mean follow-up of 9.8 years) than after BV (decreasing from 66.2 +/- 21.4 mm Hg to 21.5 +/- 15.9 mm Hg after a mean of 5.4 years; p < 0.001). Moderate pulmonary valve insufficiency occurred in 44% after surgery, and in 11% after BV (p < 0.001). Tricuspid valve insufficiency occurred in 2% after surgery, and in 5% after BV. Restenosis occurred in 3 surgical patients (5.6%), 2 patients required reoperation, and 1 patient required a balloon valvotomy. Restenosis developed in 13 BV patients (14.1%): 6 patients were redilated and 7 patients required surgery. Surgical valvotomy led to significantly less reinterventions than balloon valvuloplasty (p < 0.04). CONCLUSIONS: Surgical relief of pulmonary valve stenosis produces lower long-term gradients and results in longer freedom from reintervention. Balloon valvuloplasty may remain, despite these results, the preferred therapy for isolated pulmonary valve stenosis, because it is less invasive, less expensive, and requires a shorter hospital stay. Surgery should remain the exclusive form of therapy in the presence of concomitant intracardiac defects, which need to be addressed.

Catheterization↗
PubMed2003

Combined percutaneous treatment for pulmonary valve stenosis and atrial septal defect in an adult patient.

Pulmonary valve stenosis and atrial septal defect are common forms of congenital heart disease; however, their association is relatively rare. When the two conditions are present simultaneously, significant left-to-right shunt is often prevented by the outflow obstruction, which protects the pulmonary bed until adulthood. This work describes a case of simultaneous percutaneous treatment of both congenital malformations. Although these procedures have been applied in isolation as methods of treatment, this case demonstrates the feasibility and effectiveness of a combined percutaneous treatment.

Atherectomy↗
PubMedDate not supplied

Balloon valvuloplasty of critical pulmonary valve stenosis in a premature neonate.

Balloon dilatation of critical pulmonary valve stenosis in neonates with a weight of less than 2.5 kg is associated with specific problems, including temperature loss during the procedure, venous access, and problems related to the small size of the cardiac structures. We report our experience with balloon valvuloplasty in a premature newborn weighing 1.22 kg. Venous access was gained with a 4 French sheath, and balloon dilatation was performed with a 3.5 French 7-mm balloon catheter. Temperature loss of the baby was avoided by puncturing the femoral vein prior to the procedure on a neonatal open care system, wrapping the child in cotton, and covering the extremities with aluminium foil. The good result in our patient demonstrates that balloon valvuloplasty is a therapeutic option for treatment of critical pulmonary stenosis in premature infants.

Angiography↗