Percutaneous balloon pulmonary valvoplasty for pulmonary stenosis and atresia with intact ventricular septum in infants and neonates.

LI Hong; LI Jun-jie; SHI Ji-jun; LI Jiang-lin; ZHANG Xu; XU Yan-mei; LI Yu-fen

Abstract：Objective To assess the feasibility of Percutaneous balloon pulmonary valvoplasty(PBPV)for pulmonary stenosis and atresia with intact ventrieular septum in infants and neonates.Methods From January 2006 to April 2009 in Department of Pediatric,Guangdong Province Cardiovascular Disease Institute.63 infants and neonates(56 with pui-monary stenosis,7 with pulmonary atresia)underwent PBPV,20 of them were neonates(31.7%).In neonates with criti-cal pulmonary stenosis,valve should be predilated using a low-profile balloon.In patients with pulmonary atresia,valve should be perforated with a radiofrequeney wire,then valvuloplasty performed with a balloon approximately 1.2～1.3 times the annulus diameter(in neonates,with a balloon approximately 1.0～1.2 times the annulus diameter).Results Sixty three patients(100%)were successfully performed PBPV.The mean ratio of the balloon to annulu was(1.2±0.1).Right ventrieular systolic pressure was decreased[from(104.3±32.7)mmHg to(52.0 4±10.5)mmHg,P<0.001],the mean pressure gradient of pulmonary valve was decreased[from(99.2±23.5)mmHg to(27.7±12.4)mmHg,P<0.001].The right ventrieular angiography showed the pulmonary valves were opened.The mean procedure time was (88.1±36.2)minutes.The mean fluoroscopy time was(16.9±11.1)minutes.Six patients(9.5%)appeared complica-tioas.There were hemoperieardium in 2 patients,hypoxia in 2 patient,tricuspid valve tendon partial rupture in 1 patient and supraventrieular tachycardia in 1 patient.The mean follow-up time was(19.0±12.3)months.Three patients with moderate to severe residual pulmonary stenosis underwent a second balloon dilation at the time of follow-up 3 months.All patients had just mild pulmonary regurgitation.Conclusion PBPV for pulmonary stenosis and atresia with intact ven-trieular septum in infants and neonates is safe and effec-tive.