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Results for “PULMONARY VALVE STENOSIS”

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At least 19 recordsLinked to original sources
PubMed1990

[Konno procedure for congenital aortic valve stenosis with pulmonary valve stenosis].

Although aortic and pulmonary valve stenosis are among the most common congenital heart defects, the combination of both aortic and pulmonary valve stenosis in the same patient appears to be very uncommon. Accurate diagnosis of combined valvular stenosis is imperative prior to surgical correction, otherwise surgery of one of the lesions may result in an insufficient hemodynamic improvement. A seven-year-old girl with congenital aortic and pulmonary valve stenosis associated with hypoplastic aortic annulus underwent Konno's operation, pulmonary valvotomy and resection of anomalous muscle of the right ventricular outflow tract simultaneously. The operation was successfully performed and postoperative course was uneventful.

Aortic Valve Stenosis↗
PubMedDate not supplied

[Non-surgical treatment of pulmonary valve stenosis].

Percutaneous pulmonary valve valvuloplasty was attempted 17 times in 16 infants and children aged 15 days to 18 years. Valvuloplasty was performed during cardiac catheterization without general anesthesia. Balloon catheter was positioned across the pulmonary valve using a guide wire previously introduced in the right or left pulmonary artery. All patients experienced a decrease in the right ventricular peak systolic pressure from 111.5 +/- 35.9 to 69 +/- 28.9 mmHg (p less than 0.001), a decrease in the ratio of right ventricular pressure to systemic systolic pressure from 1.08 +/- 0.34 to 0.65 +/- 0.28 (p less than 0.001) and a decrease in right ventricular to pulmonary artery gradient from 88.52 +/- 37.2 to 54.82 +/- 29.4 mmHg (p less than 0.001). A child with a history of postoperative seizures had convulsions after the procedure and died 72 hours later. Four other patients are considered as a failure of the technique, 4 had clear hemodynamic improvement but right ventricular pressure remained above 50 mmHg, and 8 had satisfactory relief of their stenosis with a right ventricular pressure below or equal to 50 mmHg and a right ventricular to pulmonary artery gradient below 30 mmHg. These good results were confirmed in 2 patients, one year after the dilatation. Percutaneous balloon valvuloplasty is probably now the best treatment for pulmonary valvular stenosis. Short-term and results at distance from the procedure are good, and morbidity and cost are less than those for a surgical cure.

Adolescent↗
PubMed1990

Percutaneous balloon valvuloplasty of pulmonary valve stenosis, dysplasia, and residual stenosis after surgical valvotomy for pulmonary atresia with intact ventricular septum: long-term results.

Eight-six children (aged 20 days to 14 years, 20 under age 1 year) underwent 94 percutaneous balloon valvuloplasty for pulmonary valve stenosis. The patients were divided into three groups: typical pulmonary valve stenosis (71), pulmonary valve dysplasia (9), and residual stenosis after surgical valvotomy for pulmonary atresia with intact ventricular septum (PAIS) (6). Each of the three groups was divided into two subgroups. In the early cases, balloon catheters with diameter 10-20% exceeding pulmonary valve annulus were used and the drop of the gradient was 39.5%. In the later cases, balloon diameters 30-40% greater than the valve anulus or double balloons were used and a drop of 66.7% in the RV-PA pressure gradient was achieved. The dilation in patients with dysplastic valve and residual stenosis after surgical valvotomy for PAIS was less effective. Doppler echocardiography was the technique used to evaluate residual gradient. Six months to 4 years follow-up demonstrated a persistent decrease of the valve gradient.

Adolescent↗
PubMed1995

Balloon valvuloplasty for pulmonary valve stenosis.

Balloon valvuloplasty for pulmonary valve stenosis by static dilation is the treatment of choice for the treatment of isolated valvular pulmonary stenosis in the infant, child, and adolescent. The procedure is also effective in neonates; however, the complications of the procedure are significantly higher and the efficacy is less. This article reviews the background, indications, technique, acute and long-term results, and complications of balloon valvuloplasty for pulmonary valve stenosis in the infant, child, and adolescent with pulmonary valve stenosis. The application of this technique in neonates with critical pulmonary stenosis or membranous pulmonary atresia with intact ventricular septum is also discussed. The determinants of a successful outcome in each group are addressed.

Catheterization↗
PubMed2003

Short- and intermediate-term follow-up results of percutaneous transluminal balloon valvuloplasty in adolescents and young adults with congenital pulmonary valve stenosis.

Percutaneous pulmonary balloon valvuloplasty (PBV) is a well-established treatment alternative to surgery in many cardiology centers. We described our experience with PBV in 25 adolescent and young adult patients with isolated pulmonary valve stenosis (PVS). Among 20 successful PBVs, there was a significant immediate decrease in right ventricular systolic pressure from 116.9 32.4 mmHg to 60.5 18.7 mmHg (p < 0.0001) and a decrease in transpulmonary valve pressure gradient from 93.5 32.8 mmHg to 33.5 9.7 mmHg (p < 0.0001) was noted. The follow-up period was 1-5 years (mean = 3.2 1.2 years), during which patients were periodically assessed by Doppler echocardiogram. During follow-up, the transpulmonary valve pressure gradient further decreased from 33.5 9.7 mmHg to 18.6 3.4 mmHg (p < 0.0001) mainly due to regression of infundibular hypertrophy. Thus, the study showed excellent short-term and intermediate-term results of PBV.

Adolescent↗
PubMedDate not supplied

[Percutaneous dilatation of pulmonary valve stenosis].

We present 11 cases of pulmonary valve stenosis who underwent percutaneous dilatation angioplasty. Patients were between 2 and 15 years old (mean age = 6.5 yrs) and all of them except 3 had moderate or severe degree of valve stenosis. Pulmonary anulus diameter ranged between 11 and 23 mm. at ECHO and between 10 and 21 mm. at angio. The catheter was chosen to be 20-40% larger than pulmonary anulus. The mean pressure gradient between RV and PA was 65 mmHg. before dilatation and 21 mmHg. after the procedure. The procedures were without complications, except one in which we observed an intermittent idioventricular rhythm for few days after the procedure. Percutaneous dilatation angioplasty has to be considered the treatment of choice for pulmonary valve stenosis.

Adolescent↗
PubMed1998

Pulmonary valve annulus grows after balloon dilatation of neonatal critical pulmonary valve stenosis.

BACKGROUND: Neonates with critical pulmonary valve stenosis often demonstrate small or hypoplastic right ventricular structures. Relief of the obstruction enhances forward flow across the right ventricle and reduces its pressure load. Growth of the right ventricle and especially of the pulmonary valve annulus was evaluated after balloon dilatation. METHODS: Ten consecutive neonates with critical pulmonary valve stenosis who underwent balloon valvuloplasty were studied by serial echocardiography to assess growth of right ventricular structures at follow-up. RESULTS: The mean diameter of the pulmonary valve annulus increased from 6.1 +/- 1.4 mm to 12.6 +/- 3.5 mm (z scores from -2.9 +/- 1.0 SD to - 1.3 +/- 1.2 SD, p < 0.0001) after a mean follow-up period of 2.7 +/- 2.0 years. The mean diameter of the tricuspid valve annulus increased from 12.9 +/- 3.8 mm to 19.0 +/- 3.1 mm; however, the respective z score did not change significantly (from 0.5 +/- 2.4 SD to -0.5 +/- 1.0 SD). Right ventricular cavity size was hypoplastic in four patients initially and normal in all patients at latest follow-up. CONCLUSIONS: Balloon dilatation of critical pulmonary valve stenosis encourages catch-up growth of the pulmonary valve, and surgery may be avoided even in a hypoplastic pulmonary valve annulus.

Catheterization↗
PubMed1977

A simple method for ECG and VCG assessment of the severity of pulmonary valve stenosis.

In patients with isolated pulmonary valve stenosis, the right ventricular (RV) hypertrophy is related to the hemodynamic severity of their lesions. We estimated the peak RV pressure noninvasively in 112 patients with isolated pulmonary valve stenosis by a Frank lead vectorcardiogram (VCG), an orthogonal electrocardiogram (ECG), and a standard scalar ECG. In 78 randomly assigned patients, 10 ECG measurements and 13 VCG measurements were correlated with the peak RV pressure at cardiac catheterization; the best multiple linear regression equation used the R wave in standard lead 1 (ECG), maximal rightward voltage in the terminal part of the frontal vector loop (VCG), and the Q wave in the orthogonal Z lead, giving R = 0.66 (SEM 25). The equation was validated in the other 34 patients; correlation of estimated with actual peak RV pressure was r = 0.64. A nomogram for clinical use was devised from this regression equation.

Adolescent↗
PubMed1985

Percutaneous balloon valvuloplasty for pulmonary valve stenosis in infants and children.

Pulmonary valve stenosis was relieved by balloon dilatation during cardiac catheterisation on 27 occasions in 23 infants and children aged 7 days to 12 years, median 31 months (three aged less than 2 weeks). Pulmonary valve diameter was estimated by cross sectional echocardiography to assist in the choice of balloon size. Before dilatation the right ventricular systolic pressure ranged from 41 to 190 (median 92) mm Hg and was suprasystemic in 10 patients. There were significant reductions in the ratio of right ventricular to systemic systolic pressure and pulmonary systolic pressure gradients immediately after balloon dilatation. Twelve patients underwent recatheterisation (11 at six months and one at one week after balloon dilatation), which showed further improvement with significant reductions in right ventricular pressure or pulmonary valve gradient or both, particularly in the patients with the least satisfactory initial results. This improvement was attributed to resolution of the obstruction at infundibular level. Repeat pulmonary valve dilatation was successfully performed in four patients who had poor results after initial dilatation. Balloon pulmonary valvotomy appears to provide good short term and medium term relief of pulmonary valve stenosis and may obviate the need for surgery in many cases. An apparently poor immediate haemodynamic result does not preclude a good longer term result.

Angiography↗
PubMedDate not supplied

[Surgical treatment of pulmonary valve stenosis].

"Open" pulmonary valvotomy with vena cava occlusión and normothermia was first performed by Varco in 1950, but the procedure was abandoned with the arrival of extracorporeal circulation. This paper compares two groups of patients who were operated with Varco's procedure and extracorporeal circulation. Similar data of both procedures are analyzed as well as their advantages and disadvantages. It is concluded that Varco's proceduce is useful in well selected patients with no associated anomalies in which the possibility of complications of extracorporeal circulation is avoided. Also, equipment, personnel, surgical time and stay in the Intensive Care Unit and in the hospital are reduced, saving cost as much as 50%.

Body Temperature↗
PubMed1993

[Anesthetic management of a neonate with critical pulmonary valve stenosis for balloon pulmonary valvuloplasty].

We administered general anesthesia for balloon pulmonary valvuloplasty (BPV) to a 19 day-old male infant, weighing 2,789g, with critical pulmonary stenosis. The patient had severe cyanosis and mild right heart failure. Atropine (0.01 mg.kg-1) was administered intravenously immediately before induction of anesthesia. Pancuronium (0.4 mg) was used to facilitate endotracheal intubation and for the subsequent control of ventilation. Anesthesia was maintained with oxygen and enflurane (0.25 approximately 0.5%) supplemented with intravenous administration of fentanyl (1.5 micrograms.kg-1). During catheterization for balloon pulmonary valvuloplasty, SpO2 and blood pressure decreased temporarily to 35% and 50 mmHg, respectively. Several side effects of balloon inflation have been reported, such as bradycardia, arrhythmia, and the decrease in systemic blood pressure and arterial oxygen saturation, mainly due to the occlusion of pulmonary blood flow. Therefore, it might be recommended that BPV should be performed under stable state of general anesthesia with continuous monitorings of especially ECG, arterial blood pressure, central temperature, SpO2, ETCO2 and urine output.

Anesthesia, General↗
PubMed1977

Lung hypoplasia in congenital pulmonary valve stenosis.

The pulmonary function of ten adult patients with congenital pulmonary valvular stenosis was investigated. The patients clearly showed smaller lungs than healthy control subjects of equivalent age and height; lung elastic recoil pressure was normal at any given percentage of measured total lung capacity, indicating that postnatal parenchymal damage is not the cause of the small lungs. The lung diffusing capacity for carbon monoxide was reduced, reflecting the anatomical alterations of the pulmonary vascular bed. Finally, the maximal flow-static recoil curves showed a fixed (not dynamic) reduction of airway dimensions: the critical transmural pressure in the collapsible flow-limiting segment (Ptm') was normal, but the conductance of the S segment was lowered. These abnormalities most likely reflect inadequate development of the lung and suggest that pulmonary blood pressure may be an important determinant of lung growth in the postnatal period.

Adolescent↗
PubMed1996

Partial anomalous pulmonary venous drainage associated with intact atrial septum and pulmonary valve stenosis.

Partial anomalous pulmonary venous drainage (PAPVD) with an intact atrial septum is a very rare cardiovascular anomaly. Most PAPVD cases can be detected by echocardiographic scanning of the anomalous pulmonary venous connection. This paper describes an asymptomatic 6-year-old boy who was referred because of a heart murmur. An electrocardiogram and two-dimensional echocardiography revealed right heart volume overload. Mild pulmonary valve stenosis and an intact atrial septum were noted. In addition, color flow mapping demonstrated the right upper pulmonary vein connecting to the superior vena cava. This paper emphasizes that two-dimensional echocardiography in conjunction with color flow mapping is a valuable modality in the detection of anomalous pulmonary venous drainage.

Child↗
PubMed1999

Percutaneous balloon valvuloplasty for congenital pulmonary valve stenosis in adults.

BACKGROUND: Although pulmonary valvular stenosis is not uncommon in adults, there are few reports of percutaneous pulmonary valvuloplasty in adults, despite the possibility of avoiding heart surgery. AIM: This report describes the experience in adult patients undergoing this procedure and evaluates its effectiveness and tolerance. METHODS: Over an 8-year period (1989-1997), pulmonary valvuloplasty was considered in 22 adult patients [8 men, 14 women; mean age 28.0 years +/- standard deviation (SD) 10.3; range 16-46 years] with congenital pulmonary valve stenosis. Sixteen patients were asymptomatic with pulmonary systolic murmurs, although 6 patients presented with dyspnea. Before the procedure, the mean transpulmonary valve gradient was 53.2 +/- 24.8 mmHg SD, with a mean right ventricular systolic pressure of 74.6 +/- 28.4 mmHg SD, and mean pulmonary artery pressure was 21.4 +/- 6.4/10.2 +/-3.9 mmHg. RESULTS: The procedure was successful in 19 patients (6 men, 13 women) and was well tolerated and free of complications. Following the procedure, the mean transvalvular gradient was 15.5 +/- 11.5 mmHg, with a mean right ventricular systolic pressure of 40.5 +/- 13.6 mmHg and a mean pulmonary systolic pressure of 24.3 +/- 7.4 mmHg. This represented mean fall in transpulmonary valve gradient of 42.4 +/- 22.0 mmHg (paired t-test, p < 0.0001). After a mean follow-up of 20.1 months (13.4 SD), most patients remained well and asymptomatic, although two patients required repeat valvuloplasty. CONCLUSION: Pulmonary valvuloplasty is a well tolerated and effective treatment for pulmonary valve stenosis in adults, with few complications and no need for surgery. This procedure should be considered as the primary treatment of adult patients with pulmonary valve stenosis.

Adolescent↗