Major Determinants and Long-Term Outcomes of Successful Balloon Dilatation for the Pediatric Patients with Isolated Native Valvular Pulmonary Stenosis: A 10-Year Institutional Experience.
10.3349/ymj.2008.49.3.416
- Author:
Meng Luen LEE
1
;
Jui Wen PENG
;
Guo Jhueng TU
;
San Yi CHEN
;
Jyong You LEE
;
Shu Lin CHANG
Author Information
1. Department of Pediatrics, Division of Pediatric Cardiology, Cardiac Catheterization, Changhua Christian Hospital, Changhua 50050, Taiwan. ferdielee@yahoo.com
- Publication Type:Original Article
- Keywords:
Balloon dilatation;
pediatric;
valvular pulmonary stenosis
- MeSH:
Adolescent;
Balloon Dilatation/adverse effects/*methods;
Child;
Child, Preschool;
Echocardiography;
Female;
Follow-Up Studies;
Humans;
Infant;
Infant, Newborn;
Male;
Pulmonary Valve Stenosis/pathology/physiopathology/*therapy;
Retrospective Studies;
Time Factors;
Treatment Outcome
- From:Yonsei Medical Journal
2008;49(3):416-421
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We report herein major determinants and long- term outcomes of balloon dilatation (BD) for 27 pediatric patients with isolated native valvular pulmonary stenosis (VPS). MATERIALS AND METHODS: From May 1997 to May 2003, 27 pediatric patients with VPS (pressure gradients> or =40mmHg) were enrolled in this retrospective study. Single-balloon maneuver was applied in 26 patients, and double- balloon maneuver in 1. After BD, the pressure gradients were documented simultaneously by pullback maneuver by cardiac catheterization and echocardiography within 24 hours, at 1- month, 3-month, 1-year, and 4-to-10-year follow-ups. RESULTS: Before BD, the echocardiographic gradients ranged from 40 to 101mmHg (61+/-19, 55), and from 40 to 144mmHg (69+/-32, 60) by pressure recordings. After BD, the gradients ranged from 12 to 70mmHg (29+/-13, 27) by pressure recording (p<0.001), and from 11 to 64mmHg (27+/-12, 26) by echocardiography within 24 hrs (p<0.001). The ratios of the systolic pressure of the right ventricle to those of the left ventricle were 55 to 157% (89+/-28, 79%) before BD, and 30 to 79% (47+/-13, 42%) after BD p<0.001). Follow-up (7.7+/-5.7, 4.5 years) echocardiographic gradients ranged from 11 to 61mmHg (25+/-11, 24). Two patients did not have immediate success owing to infundibular spasm. Improved right ventricular compliance could be accounted for the ultimate success in these 2 patients. The ultimate successful rate was 100%. CONCLUSION: BD can achieve excellent long-term outcomes in the pediatric patients with isolated native VPS.
