Clinical efficacy analysis of percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis guided by ultrasound_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SUN Bao ¹ ,  CHENG Duan ¹ , LI Bo ² , HE Guibao ¹ , WANG Haifeng ¹ , Ahathi ¹ , Elias ¹ , SHENG Xi ¹ , LI Jinpeng ¹

1. Department of Cardiac Surgery, Xinjiang Cardiac and Neurovascular Disease Hospital, Urumqi, 830011, P.R.China;
2. Department of Ultrasound, Xinjiang Cardiac and Neurovascular Disease Hospital, Urumqi, 830011, P.R.China;

Corresponding author：

CHENG Duan, Email: chengduan@126.com

Keywords：

Echocardiography; pulmonary valve stenosis; femoral vein; balloon dilatation

DOI：

10.7507/1007-4848.202002007

Video：

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Objective To analyze the efficacy and safety of percutaneous balloon pulmonary valvuloplasty (PBPV) for pulmonary valve stenosis guided by ultrasound.Methods From March 2016 to July 2019, 32 patients with pulmonary valve stenosis were treated in our hospital. There were 19 males and 13 females with an average age of 1-12 (6.2±3.1) years and weight of 7-45 (22.7±9.2) kg. The clinical efficacy of PBPV guided by transthoracic echocardiography (TTE) was evaluated.Results The transvalvular pressure gradient (PG) of the patients before PBPV was 65.4±11.9 mm Hg. All patients successfully received PBPV under TTE guidance. The PG was 19.7±4.0 mm Hg immediately after operation, which was significantly decreased (P<0.001). All patients survived without any serious complications. The PG values at 3 months, 6 months and 12 months after operation were 18.4±4.0 mm Hg, 16.4±3.9 mm Hg, 15.2±3.3 mm Hg, respectively, which were significantly lower than that before the operation (P<0.001).Conclusion PBPV guided by echocardiography is safe and effective in the treatment of pulmonary valve stenosis with low complications rate.

Citation： SUN Bao, CHENG Duan, LI Bo, HE Guibao, WANG Haifeng, Ahathi, Elias, SHENG Xi, LI Jinpeng. Clinical efficacy analysis of percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis guided by ultrasound. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(12): 1418-1422. doi: 10.7507/1007-4848.202002007 Copy

1.	Liu X, Liu G, Wang P, et al. Prevalence of congenital heart disease and its related risk indicators among 90,796 Chinese infants aged less than 6 months in Tianjin. Int J Epidemiol, 2015, 44(3): 884-893.
2.	Kan JS, White RI Jr, Mitchell SE, et al. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med, 1982, 307(9): 540-542.
3.	Deora S, Vyas C, Shah S, et al. Percutaneous balloon pulmonary valvuloplasty: a modified over-the-wire Inoue balloon technique for difficult right ventricular anatomy. Indian Heart J, 2014, 66(2): 211-213.
4.	Tefera E, Qureshi SA, Bermudez-Cañete R, et al. Percutaneous balloon dilation of severe pulmonary valve stenosis in patients with cyanosis and congestive heart failure. Catheter Cardiovasc Interv, 2014, 84(2): E7-E15.
5.	Devanagondi R, Peck D, Sagi J, et al. Long-term outcomes of balloon valvuloplasty for isolated pulmonary valve stenosis. Pediatr Cardiol, 2017, 38(2): 247-254.
6.	潘湘斌, 胡盛寿, 欧阳文斌, 等. 单纯超声引导下经皮肺动脉瓣球囊成形术的应用研究. 中华小儿外科杂志, 2015, 36(4): 286-288.
7.	Ou-Yang WB, Li SJ, Wang SZ, et al. Echocardiographic guided closure of perimembranous ventricular septal defects. Ann Thorac Surg, 2015, 100(4): 1398-1402.
8.	Schubert S, Kainz S, Peters B, et al. Interventional closure of atrial septal defects without fluoroscopy in adult and pediatric patients. Clin Res Cardiol, 2012, 101(9): 691-700.
9.	Massara M, Finocchiaro P, Volpe A, et al. Percutaneous drug-eluting balloon angioplasty to treat dialysis access stenosis. Semin Vasc Surg, 2017, 30(2-3): 67-69.
10.	杨博鑫, 李言, 武王将, 等. 心血管介入手术辐射剂量影响因素的分析. 北京生物医学工程, 2019, 38(2): 171-176.
11.	王帆, 尹建东. 儿童介入治疗辐射剂量影响因素及防护措施研究. 影像技术, 2019, 31(5): 29-31.
12.	国家卫生健康委员会国家心外介入质控专家组, 国家心血管病中心医疗质量控制中心心外介入专家组. 单纯超声心动图引导经皮介入技术中国专家共识. 中国循环杂志, 2018, 33(10): 943-952.
13.	孙保, 程端, 李波, 等. 单纯超声引导下经股静脉封堵筛孔型房间隔缺损的疗效评价. 中国胸心血管外科临床杂志, 2019, 26(9): 889-894.
14.	孙保, 程端, 李波, 等. 超声引导下经皮逆行法封堵未闭动脉导管的有效性和安全性. 中国胸心血管外科临床杂志, 2019, 26(12): 1208-1212.
15.	牟莉, 彭燕, 马琼英. 儿童胸部X线、CT 检查的应用选择. 中华肺部疾病杂志(电子版), 2018, 11(4): 479-480.
16.	杨贵明, 江荣, 赵胜, 等. 经皮球囊肺动脉瓣成形术治疗儿童肺动脉瓣狭窄53例临床分析. 安徽医学, 2016, 37(6): 741-743.
17.	谢涌泉, 闫军, 花中东, 等. 经胸与经皮肺动脉瓣球囊成形术治疗肺动脉瓣狭窄的临床对比研究. 中华外科杂志, 2017, 55(6): 459-462.
18.	Hong D, Qian MY, Zhang ZW, et al. Immediate therapeutic outcomes and medium-term follow-up of percutaneous balloon pulmonary valvuloplasty in infants with pulmonary valve stenosis: A single-center retrospective study. Chin Med J (Engl), 2017, 130(23): 2785-2792.
19.	Maostafa BA, Seyed-Hossien M, Shahrokh R. Long-term results of balloon pulmonary valvuloplasty in children with congenital pulmonary valve stenosis. Iran J Pediatr, 2013, 23(1): 32-36.
20.	Kim H, Sung SC, Choi KH, et al. Long-term results of pulmonary valve annular enlargement with valve repair in tetralogy of Fallot. Eur J Cardiothorac Surg, 2018, 53(6): 1223-1229.
21.	庹娟, 陈沅, 李谧, 等. 经皮球囊肺动脉瓣成形术治疗儿童肺动脉瓣狭窄合并瓣下狭窄及瓣上狭窄的临床分析. 重庆医科大学学报, 2015, 40(4): 516-521.
22.	江勇, 欧阳文斌, 张丽, 等. 单纯超声引导儿童经皮肺动脉瓣狭窄球囊成形术的应用价值. 中华超声影像学杂志, 2016, 23(6): 475-479.
23.	孙丹丹, 侯颖, 袁丽君, 等. 超声多普勒方法估测肺动脉平均压的效果比较. 中国超声医学杂志, 2016, 32(8): 714-716.
24.	岳国栋, 孙东艳, 董明华. 胎儿心脏超声序列切面检查在胎儿先天性心脏病诊断中的临床价值分析. 中国妇幼保健, 2018, 33(14): 3333-3335.
25.	罗培, 李成, 王锦亮, 等. 超声监测与心血管造影在小儿先天性心脏病介入治疗中的指导作用. 中国医药, 2019, 14(11): 1632-1635.
26.	Wang SZ, Ou-Yang WB, Hu SS, et al. First-in-human percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance only. Congenit Heart Dis, 2016, 11(6): 716-720.

1. Liu X, Liu G, Wang P, et al. Prevalence of congenital heart disease and its related risk indicators among 90,796 Chinese infants aged less than 6 months in Tianjin. Int J Epidemiol, 2015, 44(3): 884-893.
2. Kan JS, White RI Jr, Mitchell SE, et al. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med, 1982, 307(9): 540-542.
3. Deora S, Vyas C, Shah S, et al. Percutaneous balloon pulmonary valvuloplasty: a modified over-the-wire Inoue balloon technique for difficult right ventricular anatomy. Indian Heart J, 2014, 66(2): 211-213.
4. Tefera E, Qureshi SA, Bermudez-Cañete R, et al. Percutaneous balloon dilation of severe pulmonary valve stenosis in patients with cyanosis and congestive heart failure. Catheter Cardiovasc Interv, 2014, 84(2): E7-E15.
5. Devanagondi R, Peck D, Sagi J, et al. Long-term outcomes of balloon valvuloplasty for isolated pulmonary valve stenosis. Pediatr Cardiol, 2017, 38(2): 247-254.
6. 潘湘斌, 胡盛寿, 欧阳文斌, 等. 单纯超声引导下经皮肺动脉瓣球囊成形术的应用研究. 中华小儿外科杂志, 2015, 36(4): 286-288.
7. Ou-Yang WB, Li SJ, Wang SZ, et al. Echocardiographic guided closure of perimembranous ventricular septal defects. Ann Thorac Surg, 2015, 100(4): 1398-1402.
8. Schubert S, Kainz S, Peters B, et al. Interventional closure of atrial septal defects without fluoroscopy in adult and pediatric patients. Clin Res Cardiol, 2012, 101(9): 691-700.
9. Massara M, Finocchiaro P, Volpe A, et al. Percutaneous drug-eluting balloon angioplasty to treat dialysis access stenosis. Semin Vasc Surg, 2017, 30(2-3): 67-69.
10. 杨博鑫, 李言, 武王将, 等. 心血管介入手术辐射剂量影响因素的分析. 北京生物医学工程, 2019, 38(2): 171-176.
11. 王帆, 尹建东. 儿童介入治疗辐射剂量影响因素及防护措施研究. 影像技术, 2019, 31(5): 29-31.
12. 国家卫生健康委员会国家心外介入质控专家组, 国家心血管病中心医疗质量控制中心心外介入专家组. 单纯超声心动图引导经皮介入技术中国专家共识. 中国循环杂志, 2018, 33(10): 943-952.
13. 孙保, 程端, 李波, 等. 单纯超声引导下经股静脉封堵筛孔型房间隔缺损的疗效评价. 中国胸心血管外科临床杂志, 2019, 26(9): 889-894.
14. 孙保, 程端, 李波, 等. 超声引导下经皮逆行法封堵未闭动脉导管的有效性和安全性. 中国胸心血管外科临床杂志, 2019, 26(12): 1208-1212.
15. 牟莉, 彭燕, 马琼英. 儿童胸部X线、CT 检查的应用选择. 中华肺部疾病杂志(电子版), 2018, 11(4): 479-480.
16. 杨贵明, 江荣, 赵胜, 等. 经皮球囊肺动脉瓣成形术治疗儿童肺动脉瓣狭窄53例临床分析. 安徽医学, 2016, 37(6): 741-743.
17. 谢涌泉, 闫军, 花中东, 等. 经胸与经皮肺动脉瓣球囊成形术治疗肺动脉瓣狭窄的临床对比研究. 中华外科杂志, 2017, 55(6): 459-462.
18. Hong D, Qian MY, Zhang ZW, et al. Immediate therapeutic outcomes and medium-term follow-up of percutaneous balloon pulmonary valvuloplasty in infants with pulmonary valve stenosis: A single-center retrospective study. Chin Med J (Engl), 2017, 130(23): 2785-2792.
19. Maostafa BA, Seyed-Hossien M, Shahrokh R. Long-term results of balloon pulmonary valvuloplasty in children with congenital pulmonary valve stenosis. Iran J Pediatr, 2013, 23(1): 32-36.
20. Kim H, Sung SC, Choi KH, et al. Long-term results of pulmonary valve annular enlargement with valve repair in tetralogy of Fallot. Eur J Cardiothorac Surg, 2018, 53(6): 1223-1229.
21. 庹娟, 陈沅, 李谧, 等. 经皮球囊肺动脉瓣成形术治疗儿童肺动脉瓣狭窄合并瓣下狭窄及瓣上狭窄的临床分析. 重庆医科大学学报, 2015, 40(4): 516-521.
22. 江勇, 欧阳文斌, 张丽, 等. 单纯超声引导儿童经皮肺动脉瓣狭窄球囊成形术的应用价值. 中华超声影像学杂志, 2016, 23(6): 475-479.
23. 孙丹丹, 侯颖, 袁丽君, 等. 超声多普勒方法估测肺动脉平均压的效果比较. 中国超声医学杂志, 2016, 32(8): 714-716.
24. 岳国栋, 孙东艳, 董明华. 胎儿心脏超声序列切面检查在胎儿先天性心脏病诊断中的临床价值分析. 中国妇幼保健, 2018, 33(14): 3333-3335.
25. 罗培, 李成, 王锦亮, 等. 超声监测与心血管造影在小儿先天性心脏病介入治疗中的指导作用. 中国医药, 2019, 14(11): 1632-1635.
26. Wang SZ, Ou-Yang WB, Hu SS, et al. First-in-human percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance only. Congenit Heart Dis, 2016, 11(6): 716-720.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical efficacy analysis of percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis guided by ultrasound

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