Abstract: Objective To summarize the immediate effects and the near and midterm followup results of transthoracic balloon valvuloplasty for newborns and infants with severe and critical pulmonary valve stenosis to find out an effective plan for onestop balloon valvuloplasty. Methods From March 2006 to March 2010, 32 patients including 23 males and 9 females with severe and critical pulmonary valve stenosis were treated in Fu Wai Hospital. Their age ranged from 5 days to 11 months (4.59±3.21 months). Weight of the patients ranged from 2.3 to 10.5 kg (6.48±2.05 kg). Dilatation was performed under general anesthesia with intubation and the guidance of echocardiography. During the follow-up period, all survivors had serial echocardiographic assessment to measure the transpulmonary pressure gradient (TPG) and the degree of pulmonary regurgitation. Results All operations were successful with no severe postoperative complications. Hemodynamic indexes were stable after operation with TPG lowered from from 82±27 mm Hg preoperatively to 23±12 mm Hg postoperatively (t=15.28, Plt;0.05). Only 4 patients had a TPG of more than 40 mm Hg on echocardiography before leaving the hospital. Tricuspid regurgitation was decreased significantly with 17 cases of nonregurgitation, 13 cases of light regurgitation and 2 cases of moderate regurgitation. Saturation of peripheral oxygen in all the patients increased to higher than 95%. Followup time ranged from 1 month to 4 years (16±11 months). The results of the follow-up were satisfying for all the patients. The average TPG was 17±10 mm Hg with only one above 40 mm Hg. Pulmonary valve regurgitation was found in 24 patients including 23 with light pulmonary regurgitation and 1 with moderate regurgitation. Conclusion Transthoracic balloon valvuloplasty for newborns and infants with severe and critical pulmonary valve stenosis is safe and effective.
Abstract: Percutaneous balloon pulmonary valvuloplasty (PBPV) has become the first choice for the treatment of pulmonary valve stenosis (PS). PBPV is used not only in the independent way to relieve Milo-Ⅰ amp; Ⅱ type of PS as an alteration of surgery, but also in the combination way with surgical treatment to some multiple or complex congenital heart defect,where it plays a part as a pre-operative appeasement or a co-operative procedure, even a supplementary expedience to some failed surgery post-operatively. In this paper, the anatomic classification of PS, the usage of ultrasounic examination, the indication and contraindication, the method and skill during operation, and the effect evaluation of PBPV are reviewed.
ObjectiveTo analyze the efficacy and safety of percutaneous balloon pulmonary valvuloplasty (PBPV) for pulmonary valve stenosis guided by ultrasound.MethodsFrom 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.ResultsThe 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).ConclusionPBPV guided by echocardiography is safe and effective in the treatment of pulmonary valve stenosis with low complications rate.