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Results for “PULMONARY VALVE STENOSIS”

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At least 469 records · Page 26Linked to original sources
PubMed1992

[Balloon pulmonary valvuloplasty after initial pulmonary valvotomy for pulmonary atresia with intact ventricular septum].

Seven patients with pulmonary atresia and intact ventricular septum have undergone closed pulmonary valvotomy on the early neonatal period (2-6 days) with satisfactory results. Follow-up catheterization showed significant residual pulmonary valve stenosis requiring a second operation. Percutaneous balloon dilatation of the pulmonary valve was successful in 6 cases with the mean right ventricular systolic pressure reduced from 6.8 to 4.9 kPa (50.8 to 37 mmHg) and the mean transvalvular gradient dropped from 5.7 to 2.1 kPa (4.28 to 15.8 mmHg). One case failed and required surgical treatment. The results showed that balloon valvuloplasty could be applied instead of surgery for treatment of selected cases of pulmonary atresia with intact ventricular septum after an initial pulmonary valvotomy.

Catheterization↗
PubMedDate not supplied

Aneurysm of the membranous septum in critical pulmonary stenosis: spontaneous rupture after balloon dilatation.

We report a case of critical pulmonary valve stenosis in which congenital aneurysm of the membranous septum ruptured spontaneously after balloon dilatation of the pulmonary valve. It is considered that the chronic mechanical trauma with phasic protrusion and collapse of the aneurysm during the cardiac cycles was responsible for an aneurysm rupture.

Aneurysm, Ruptured↗
PubMed2002

Pulmonary valvuloplasty in a case of vascular Ehlers-Danlos syndrome.

A 15-year-old girl with known Ehlers-Danlos syndrome (EDS) type IV presented with severe pulmonary valve stenosis requiring intervention. We describe successful pulmonary valvuloplasty using a 90% balloon/annulus angioplasty balloon. The procedure was complicated by early restenosis suggesting an abnormal scarring response in EDS IV.

Adolescent↗
PubMed1993

[Quantification of postoperative pulmonary valve insufficiency: severity and clinical symptoms].

Surgical treatment of pulmonary stenosis may lead to inevitable valvular incompetence. The hemodynamic and clinical significance of post-operative pulmonary insufficiency (PI) is uncertain. In patients presenting cardiomegaly and reduced exercise tolerance reoperation may be considered. However, pulmonary valve replacement remains controversial. In order to elucidate the relevance of PI in the long-term post-operative course, quantitative data of PI were compared with chest radiographs and the physical condition. Thirty-one patients with a mean age of 18.5 years (3-36 years) were studied. Twenty-two patients had surgical correction of Tetralogy of Fallot (TOF) and nine had commissurotomy of pulmonary valve stenosis (PS). Catheterization was performed, on average, 12.9 years (2-29 years) after operation in 68% of cases with an interval of more than 10 years. PI was quantitated by digital roentgen densitometry. Regurgitant fraction (RGF) ranged between 13-61%, according to a right ventricle volume load index (VBI) of 1.15-2.6 (ratio of total to effective stroke volume). Twenty of 31 patients (12 TOF, 8 PS) had PI as the only significant lesion. VBI (1.15-2.6) correlated with the cardio thoracic ratio (0.50-0.64), r = 0.74. All patients were in good physical condition. 11 actively took part in sports: all of the eight patients studied by ergometry met normal conditions. Four patients had antiarrhythmic medication. Eleven of 31 patients had PI and additional abnormalities: tricuspid insufficiency (4), right ventricular pressure overload (5), ventricular septal defect (1), depressed left ventricular function (5), and aortic insufficiency (3).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Surgical management of isolated multiple ventricular septal defects. Logical approach in 130 cases.

From January 1980 through September 1990, 130 children underwent surgical closure of isolated multiple ventricular septal defects (mean age 14 +/- 18 months, mean weight 7.0 +/- 4.4 kg). Sixty-one were less than 1 year of age. Sixty-one children had pulmonary protection, 51 had pulmonary artery banding, and 10 had pulmonary valve stenosis. All other patients had severe pulmonary hypertension (mean systolic pressure 75.7 +/- 20.5 mm Hg and already disabling heart failure (New York Heart Association classes III and IV). The surgical management was based on the location of the defects and the ventricular dominance that were assessed preoperatively and intraoperatively. Midtrabecular ventricular septal defects were always centered by the moderator band and were therefore divided into low trabecular, midtrabecular, and high trabecular defects. The perimembranous septum was involved in 102 patients, the trabecular in 121, the inlet septum in 12, and the infundibular septum in 9. Fifty patients had the "Swiss cheese" form of the lesion. Closure of the ventricular septal defects included Dacron patch and mattress sutures. They were always first approached through a right atriotomy, which was sufficient for complete repair in 82 patients. In midtrabecular ventricular septal defects, section of the moderator band (n = 24) allowed closure of all the defects with a single Dacron patch. In 48 patients a right atriotomy and a right (n = 32) or left (n = 14) (particularly for low trabecular ventricular septal defects) or both right and left (n = 2) ventriculotomies were necessary to secure the repair. The hospital mortality rate was 7.7% (10 patients). The causes of deaths were residual ventricular septal defect (n = 5), pulmonary hypertension (n = 2), hypoplastic right ventricle (n = 1) and left ventricle (n = 1), and myocardial infarction (n = 1). Among eighteen survivors with residual ventricular septal defect, six were reoperated on; there were two deaths. A permanent pacemaker was necessary in four patients. Low trabecular ventricular septal defects and left ventriculotomy were significant risk factors for morbidity (death, residual ventricular septal defect), p less than 0.01. At 7 years of follow-up, 90% of survivors were in New York Heart Association class I. Actuarial survival and freedom from reoperation at 7 years were 89.6% and 87.5%, respectively.

Abnormalities, Multiple↗
PubMed1982

Second operations for pulmonary stenosis or insufficiency after repair of tetralogy of Fallot.

Twenty-four patients with previous surgery for repair of tetralogy of Fallot were in need of subsequent operative procedures for either residual pulmonary stenosis or pulmonary valve incompetence. The second operation was performed 1 to 21 years after the initial repair. The patients with pulmonary valve incompetence had evidence of marked right ventricular dysfunction and required pulmonary valve replacement. The patients with residual pulmonary stenosis had modifications of their pulmonary outflow tract to reduce the gradient. Five of the 15 patients with stenosis required pulmonary valve replacement. Clinical improvement has been good, but objective reversal of right ventricular dysfunction has been difficult to document.

Adult↗
PubMed1985

Accuracy of two-dimensional echocardiography in the diagnosis of congenital heart disease.

To assess the accuracy of 2-dimensional (2-D) echocardiography in the evaluation of cardiac anatomy in patients with congenital heart disease, 2-D echocardiograms were performed in 126 infants and children before cardiac catheterization and angiocardiography. The segmental echocardiographic analysis included determination of intracardiac, great artery, systemic venous and pulmonary venous anatomy. The 126 patients had 259 separate cardiovascular abnormalities, of which 226 (87%) were prospectively identified by 2-D echocardiography. There were 8 false-positive diagnoses. The most common lesions and the sensitivity and specificity of echocardiography were: patent ductus arteriosus, 41 patients (83% and 100%, respectively), ventricular septal defect, 35 patients (86% and 100%); atrial septal defect, 26 patients (85% and 99%); pulmonary valve stenosis, 25 patients (77% and 97%), transposition of the great arteries, 16 patients (100% and 100%); and total anomalous pulmonary venous connection, 14 patients (85% and 100%). Less common defects and their rate of detection included coarctation of the aorta, 10 of 12 patients; atrioventricular canal, 10 of 10 patients; tetralogy of Fallot, 10 of 10 patients; aortic valve stenosis 8 of 8 patients; right aortic arch, 8 of 8 patients; interrupted aortic arch, 4 of 4 patients; and unilateral pulmonary vein atresia, 0 of 1 patient. In 33 patients (26%), the errors in echocardiographic analysis were judged to have surgical importance. Most errors were the result of overlooking or misinterpreting data that had been appropriately recorded on videotape. Pulmonary valve stenosis and patent ductus arteriosus are the lesions most likely to be misdiagnosed by ultrasound studies relying on imaging alone.

Cardiac Catheterization↗
PubMed1983

Diagnosis of right ventricular outflow obstruction in infants by cross sectional echocardiography.

Cross sectional echocardiographic studies were assessed prospectively in 58 infants in whom right ventricular outflow obstruction was subsequently shown angiographically. A subcostal cut was used to display simultaneously the short axis of the aortic root and the long axis of the right ventricular outflow tract. This facilitated the differentiation of the common right ventricular outflow tract obstructive lesions. Tetralogy of Fallot was diagnosed correctly in 22 of 26 infants; pulmonary atresia with intact septum in all of 14 neonates; isolated severe pulmonary valve stenosis in all of nine infants; and pulmonary atresia with ventricular septal defect in eight of nine infants. The subcostal approach is the technique of choice for evaluating right ventricular outflow tract obstruction as it is more reliable than the left parasternal approach.

Coronary Circulation↗
PubMed1981

A comprehensive scoring system for evaluating Noonan syndrome.

A multidisciplinary team assessed 23 patients with various manifestations of the Noonan syndrome, including pulmonary valve stenosis (with leaflet dysplasia), "typical" facial appearance (including hypertelorism, epicanthic folds, flat nasal bridge, and apparently low-set ears), short stature, and mental retardation. Seven patients had a family history of the syndrome. A comprehensive scoring system was devised on the basis of frequency and severity of manifestations and results of invasive and noninvasive tests in these patients and those reported in the literature. The scoring system was condensed into a score card for clinical use and validated by "blind" application to patients with isolated pulmonary valve stenosis or suspected Noonan syndrome. Use of a scoring system to diagnose a syndrome for which there is no specific diagnostic test facilitates accuracy and decreases observer bias. In the case of unusual congenital disorders it is particularly valuable for a pediatrician in general practice.

Adolescent↗