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At least 73 records · Page 4Linked to original sources
PubMed1989

[Treatment using balloon catheterization of pulmonary valve stenosis].

From October 84 to September 88 we performed pulmonary valvuloplasty with balloon catheter (PVBC) in 90 patients (pt) with pulmonary valve stenosis (PVS). The patients were divided in 3 groups (Gr) by their ages: group I (Gr. I) 7 pt (8%) aged 4 days to 11 months, Gr. II 66 pt (73%) aged 1 year to 12 years and Gr. III 17 pt aged 13 to 34 years. This study consists of clinical and echocardiographic evaluation adopting the following parameters of indication: a) transvalvar pulmonary gradient (G); b) absence of dysplasia or hypoplasia of the pulmonary annulus. There were associated lesions which were found in each group: Gr. I atrial septal defect (ASD) in 2 pt and tricuspid insufficiency (TI) in 1 pt, in Gr. II supra valvar stenosis (SVS) in 1 pt and patent arterial ductus (PAD) in 1 pt and in the Gr. III (ASD) in 1 pt. The results after pulmonary valvuloplasty with balloon catheter (PVBC) were: (Gr.I) in 5 pt the G were reduced below 50 mmHg and the average of right ventricular systolic pressure (RVSP) changed from 92 to 62 mmHg and the average of G from 76 to 44 mmHg. One of these pt was submitted to surgery 1 month after the procedure and 2 developed restenosis in 2 and 3 years respectively, being submitted to another dilatation with good results. The 2 pt in which the procedure was not effective were submitted to surgery. In the second group the PVBC was effective in 61 pt (92%) showing the RVSP changed from 118 to 64 mmHg and G changed from 86 to 23 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Pulmonary valvuloplasty with a balloon catheter in calcified pulmonary valve stenosis].

Since the first pulmonary valvuloplasty report, the procedure has been used frequently, becoming the best option in isolated valvar pulmonary stenosis. Pulmonary valvuloplasty in adults with calcified valvar pulmonary stenosis, however, has been minimal. We have reported the case of a 62-year-old female patient, with calcified valvar pulmonary stenosis, who underwent valvuloplasty with balloon catheter and showed a decrease in the transvalvular systolic gradient, thus proving the success of post procedure.

Calcinosis↗
PubMed1996

[Aortico-left ventricular tunnel associated with pulmonary valve stenosis].

Aortico-left ventricular tunnel is an unusual cardiac anomaly. The main clinical feature is early, severe aortic regurgitation, and surgical management is mandatory. Exceptionally this defect is associated with pulmonary valve stenosis. A case of a newborn with aortico-left ventricular tunnel plus pulmonary valve stenosis is reported. Initially she underwent percutaneous pulmonary valvuloplasty during diagnostic cardiac catheterization and with surgical closure of the tunnel later.

Aorta, Thoracic↗
PubMedDate not supplied

Device closure of an atrial septal defect following successful balloon valvuloplasty in a neonate with critical pulmonary valve stenosis and persistent cyanosis.

Persistent cyanosis after successful balloon valvuloplasty for neonatal critical pulmonary valve stenosis is often related to poor right ventricular compliance and right-to-left shunting at the atrial level. A successful catheter closure of an atrial septal defect was performed with a dramatic increase in systemic oxygen saturation alleviating the need for a surgical systemic-to-pulmonary artery shunt.

Catheterization↗
PubMed1988

Angiographic features associated with percutaneous balloon valvotomy for pulmonary valve stenosis.

Changes in the mobility of the pulmonary valve were determined by a retrospective review of right ventricular cineangiograms from 25 balloon pulmonary valvotomy (BV) procedures in 23 infants and children. The angiographic changes were compared with the post-BV catheter and Doppler pressure gradients across the right ventricular outflow tract. Angiographic features felt to indicate valve tearing were present following 17 of 25 procedures and included increased excursion or straightening of leaflets, localized change in leaflet motion (flail leaflet), and the presence of an additional contrast jet through the valve. There was no statistically significant relationship between any of the angiographic parameters and the pressure data. Most patients with marked increase in angiographic valve mobility had low residual right ventricular to pulmonary artery gradients. However, the absence of angiographic change was not always associated with a high residual gradient.

Catheterization↗
PubMedDate not supplied

Right ventricular myocardial sinusoidal-coronary artery connections in critical pulmonary valve stenosis.

Ventriculo-coronary arterial connections are frequently observed in pulmonary atresia with intact interventricular septum. Sustained right ventricular hypertension during cardiac morphogenesis is thought to be responsible for persistence of myocardial sinusoidal-coronary artery connections. Considering an unusual observation of ventriculo-coronary arterial connections in a patient with critical pulmonary valve stenosis, we speculate that sinusoidal connections in pulmonary atresia with intact ventricular septum occur not only because it is the only exit for blood from the blind right ventricle, but also because of intrinsic altered morphogenesis of the right ventricle myocardium.

Abnormalities, Multiple↗
PubMed1989

Critical pulmonary valve stenosis in patients less than 1 year of age: treatment with percutaneous gradational balloon pulmonary valvuloplasty.

A new technique of percutaneous gradational balloon pulmonary valvuloplasty was used successfully in 17 infants less than 1 year of age, including four neonates, with critical congenital pulmonary valve stenosis, who would otherwise have required surgical intervention. This technique uses a sequential series of balloon catheters of gradually increasing size as a means of eventually crossing the very small valve orifice with a balloon catheter of adequate size to achieve successful pulmonary valvuloplasty. The initial dilatations were achieved with balloon catheters 2, 3, or 4 mm in diameter. Immediately after successful balloon valvuloplasty, the mean pulmonary systolic pressure gradient was reduced from 105 +/- 11 to 20 +/- 5 mm Hg. Percutaneous balloon pulmonary valvuloplasty can be performed safely with good results despite critical congenital pulmonary valve obstruction in severely ill infants.

Catheterization↗
PubMed1986

Percutaneous transluminal balloon pulmonary valvuloplasty for the relief of pulmonary valve stenosis with special reference to double-balloon technique.

PTBPV was performed 33 times in 32 patients in the Riyadh Armed Forces Hospital. Patients ranged in age from 6 months to 12 years (mean 4.5 years); average weight was 14.86 kg. Before dilatation, all patients had grade 4/6 late peaking systolic ejection murmurs, with right-axis deviation and right ventricular hypertrophy on ECG. Moderate to severe pulmonary valve stenosis (right ventricle-pulmonary artery gradient 50 mm Hg systolic) was confirmed both hemodynamically and angiographically. Balloon size was selected to be approximately 2 mm larger than the pulmonary valve anulus was over 25 were inflated to approximately 5 atmospheres of pressure. Two patients required two simultaneous balloons as the pulmonary valve anulus was over 25 mm. Predilatation peak systolic pressure gradients ranged from 50 to 245 mm Hg (mean 99.2 mm Hg); postdilatation gradients ranged from 8 to 93 mm Hg (mean 23.4 mm Hg). There were no deaths or complications. The systolic murmur with early systolic peak decreased in all but three patients. Systolic thrill disappeared in all but three patients. Follow-up at an average of 10 months revealed increasing exercise tolerance in two thirds of patients. Fourteen patients have been recatheterized at least 6 months after dilatation and showed persistent minimal gradient. We conclude that balloon valvuloplasty of pulmonary valve stenosis is an effective, safe procedure. At this writing, a total of 90 successful PTBPVs have been performed, with equally impressive results.

Angioplasty, Balloon↗
PubMed2000

[Congenital heart defects: single ventricle with pulmonary valve stenosis and malposition of the great blood vessels].

A case of two: 21 years and 39 years old male patients with congenital heart disease: Single Ventricle with pulmonary valve stenosis and L-malposition of the great vessels. In the first case the diagnosis of congenital pulmonic stenosis & tricuspid regurgitation was established after birth and during the previous period. In the second case the diagnosis of VSD was established during the recruiting checkup, when he was 18 years old. Detailed non-invasive cardiologic examination was performed (transthoracic & transoesophageal echocardiography) and the diagnosis of Single Ventricle with pulmonary valve stenosis & L-malposition of the great vessels: Double-Inlet Left Ventricle with severe symptoms (21 years old & supraventricular paroxysmal tachycardia) with middle symptoms (39 years old) were established in both cases.

Adult↗
PubMed1996

Percutaneous transluminal balloon pulmonary valvuloplasty using domestic balloon catheter for congenital pulmonary valve stenosis in children.

OBJECTIVE: To estimate the effect of percutaneous balloon pulmonary valvuloplasty (PBPV) using domestic balloon catheter for congenital pulmonary valve stenosis (PVS) in infants and children. PATIENTS AND METHODS: The data of 70 patients aged from 1.5 to 12 years (mean 5.5 +/- 3.4 years) who underwent PBPV using domestic balloon catheter for PVS in our institution were reviewed. Sixty-six patients had dome-shaped valve stenosis, and 4 had displastic valve stenosis. SaO2 reduced in 5 patients and associated open foramen ovale was noted in 23. Predilatation, right ventricular systolic pressure ranged from 60 to 234 mmHg (mean 115.75 +/- 36.15 mmHg). The systolic gradient (delta P) from right ventricle to pulmonary artery was 89.92 +/- 38.25 mmHg. Balloon diameter was selected 120%-142% of pulmonary valve annulus diameter (mean 132%). All patients were followed up for 3 months-4 years by means of clinical examination. ECG, 2D-UCG, and Doppler-UCG. RESULTS: After dilatation, delta P reduced from 89.92 +/- 38.25 to 14.65 +/- 11.40 mmHg (P < 0.001). The rate of decrease in transvalve gradient (delta P) was 83.7%. No patients experienced procedure-related events. Mid-term follow-up showed that no patients had clinical and instrumental complications. Doppler and ECG analyses showed that delta P did not change significantly similar to immediate gradient after PBPV and right ventricular hypertrophy disappeared progressively 6 months after PBPV. CONCLUSIONS: PBPV is a useful, safe and definitive procedure in the treatment of isolated PVS in infants and children. The properties and features of the balloon catheter produced by Shanghai Med-Tech Factory are similar to those of Med-Tech balloon catheter of U.S.A.

Catheterization↗
PubMed2004

[Short- and long- term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis].

OBJECTIVE: To assess the long-term results of percutaneous balloon valvuloplasty at a single institution. METHODS: This study comprised 189 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty from 1984 to 1996, whose mean age was 7.97+/-9.25 years. The procedure was classified as successful when the RV-PA gradient was reduced to levels < 36 mmHg; restenosis was indicated by RV-PA gradients > 36 mmHg after an effective procedure. RESULTS: After the procedure, the peak-to-peak transvalvular gradient decreased from 70.12+/-30.06 to 25.11 +/-20.23 mmHg (P<0.001). Immediate success was obtained in 148 (78.72%) patients. A later reduction in the gradient to values < 36 mmHg was obtained in 24 other patients previously categorized as unsuccessful. Therefore, percutaneous balloon valvuloplasty was considered effective in 172 (91.01%) patients. Effectiveness increased to 93.53% (159/170) in the cases of typical morphology. Follow-up ranged from 4.39+/-3 years to 13.01 years. Restenosis was observed in 24 (13.95%) patients. Pulmonary regurgitation was detected in 95.1% of the patients, being more intense than mild in 29.5% of the patients. The probability of maintaining an appropriate result, at any time point, with no restenosis was 92.29% in 2 years, 87.38% in 5 years, 82.46% in 8 years, and 64.48% in 10 years. CONCLUSION: Percutaneous balloon valvuloplasty was effective and safe for the treatment of pulmonary valve stenosis with excellent short- and long-term results.

Adolescent↗
PubMed1983

Surgical approach to critical pulmonary valve stenosis in infants less than six months of age.

During the past 7 1/2 years, 36 infants (less than or equal to 6 months of age) underwent surgical relief of critical pulmonary valve stenosis. The results of closed and open (cardiopulmonary bypass, CPB) procedures were compared. Closed procedures included Brock valvotomy (two patients) and normothermic inflow stasis with transpulmonary valvectomy (10 patients). Twenty-two patients had open procedures with valvectomy alone (five patients) and right ventricular outflow tract (RVOT) reconstruction (17 patients). Two additional patients had staged operations (shunt followed by open procedure at 3 and 5 months postoperatively). Patients who had the closed procedures, as compared with CPB, were significantly younger (10 versus 61 days, p less than 0.01) and more critically ill with congestive heart failure and acidosis. In addition, the mean peak systolic right ventricular-left ventricular pressure ratios (RVP/LVP) were higher (1.6 versus 1.4, p less than 0.02) in the closed group. There were no deaths in the closed group in contrast to six deaths among those having RVOT reconstruction (0/12 versus 6/17 or 35%, p less than 0.04). Critical obstruction of the pulmonary valve, tricuspid valve regurgitation, and hypoplastia of the right ventricle occurred more frequently in the closed group. All operative deaths resulted from right heart failure. There were no late deaths in the entire series. Three patients in the closed group (mean follow-up 2.8 years) required operations for recurrent pulmonary valve stenosis approximately 2 years postoperatively, and none in the open group (mean follow-up 2.0 years). In conclusion, despite current advances in infant CPB and care, the results from our experience suggests that closed procedures, especially inflow stasis and pulmonary valvectomy, are superior to the use of CPB and RVOT reconstruction, even in the presence of pulmonary valve dysplasia.

Blood Gas Analysis↗
PubMed2005

Long-term follow-up of patients after surgical treatment for isolated pulmonary valve stenosis.

OBJECTIVE: To determine the long-term outcome of patients after surgical repair for pulmonary valve stenosis (PVS). PATIENTS AND METHODS: Fifty-three patients (30 males; mean - SD age, 10+/-13 years; range, 5 days to 50 years) were identified who had surgical treatment for PVS between 1951 and 1982. The status of each patient was determined by medical record review. RESULTS: The mean +/- SD age at follow-up was 43+/-15 years (age range, 19-77 years). Mean follow-up was 33 years (range, 18-51 years). At a median follow-up of 34 years, 35 reinterventions had been performed in 28 patients (53%), Including pulmonary valve replacement for free pulmonary regurgitation in 21 patients (mean interval after initial surgery, 33 years; range, 14-45 years), open valvotomy in 5 and pulmonary balloon valvuloplasty in 3 for residual PVS, closure of atrial septal defect in 2, right ventricular outflow tract reconstruction in 1, closure of iatrogenic ventricular septal defect in 1, ligation of aortopulmonary fistula in 1, and tricuspid valve annuloplasty with simultaneous coronary artery bypass grafting in 1. In addition, atrial and ventricular arrhythmias were common, occurring in 20 patients (38%). Patients who underwent reintervention were more likely to have undergone closed pulmonary valvotomy as the initial repair (P=.008). CONCLUSION: Although overall survival after surgical treatment of isolated PVS remains excellent, many patients undergo late reintervention after 30 years of follow-up, emphasizing the need for lifelong cardiac follow-up.

Adolescent↗
PubMed1994

Acute effects of balloon valvuloplasty and pacing on left ventricular performance in children with moderate pulmonary valve stenosis, analysed by systolic and diastolic pressure-volume relationships.

Right ventricular overload of volume and/or pressure type may affect left ventricular systolic and diastolic function. This has been shown in animal studies and has been suggested in non-invasive studies in man. Altered geometry of the left ventricle, myocardial hypertrophy and changes in contractile state may be responsible for the change in function. Balloon valvuloplasty is an effective treatment for isolated valvular pulmonary stenosis in children, and results in an immediate decrease of right ventricular systolic pressure. Whether this results in immediate changes in left ventricular performance is unknown. Eight children (age 5.2 to 13.9 years) with moderate pulmonary valve stenosis underwent pulmonary balloon valvuloplasty under general anaesthesia. Left ventricular function measurements before and after valvuloplasty were performed using a combined micromanometer-conductance catheter to obtain end-systolic (ESPVR) and end-diastolic (EDPVR) pressure-volume relationships employing inferior vena cava occlusion both at normal and pacing-induced increased heart rates. Pulmonary valvuloplasty resulted in a decrease in peak systolic right ventricular pressure from 62.8 +/- 13.5 to 34.4 +/- 7.3 mmHg (P < 0.001), without significant changes in left ventricular systolic and end-diastolic pressure, or in cardiac index. The ESPVR was fitted to a linear function to obtain the slope (Ees) and the volume intercept at 75 mmHg (V75). The EDPVR was fitted to an exponential function. At baseline, Ees was 1.68 +/- 0.99 mmHg.ml-1 and V75 was 33.6 +/- 21.8 ml. Neither valvuloplasty nor pacing, which increased mean heart rate from 81 to 112 beats.min-1 (P < 0.001), resulted in significant changes of the parameters Ees or V75.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Catheterization↗