Early and late results and the effects on pulmonary arteries of balloon dilatation of the right ventricular outflow tract in tetralogy of Fallot

Godart, François

doi:10.1053/euhj.1997.0751

Cited by 35 publications

(38 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our institution, only 7% of infants with primary repair under 2 months had preservation of the pulmonary valve (data to be published, D Fruitman, personal communication). Reports vary as to whether balloon dilation of the RVOT provides for growth of the pulmonary valve significant enough to allow for subsequent preservation 5 7 10. The pulmonary valve annulus diameters were extremely small in our series (mean pulmonary valve diameter of 3.7 mm (2.7–4.2) and and Z-score of −6.7 (−9.7 to −5.4)).…”

Section: Discussionmentioning

confidence: 68%

“…Reported transannular patch rates are high (36–100%) when surgery is performed in infancy 10 11 24. In our institution, only 7% of infants with primary repair under 2 months had preservation of the pulmonary valve (data to be published, D Fruitman, personal communication).…”

Section: Discussionmentioning

confidence: 77%

“…These risk factors include low weight, prematurity, young age (<3 months), unfavourable pulmonary arterial anatomy, abnormal coronary distribution and critical preoperative condition 1 – 3. Palliative procedures include surgical right ventricular outflow tract (RVOT) enlargement or conduit, aortopulmonary shunt, stenting of the arterial duct and balloon pulmonary valvuloplasty 4 – 10. While primary repair can and has been performed in these patients, it is associated with increased morbidity 1 11…”

mentioning

confidence: 99%

See 2 more Smart Citations

Stenting of the right ventricular outflow tract in the symptomatic infant with tetralogy of Fallot

Døhlen

Chaturvedi

Benson

et al. 2008

Heart

130

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 77%

mentioning

confidence: 99%

See 1 more Smart Citation

Stenting of the right ventricular outflow tract in the symptomatic infant with tetralogy of Fallot

Døhlen

Chaturvedi

Benson

et al. 2008

Heart

130

View full text Add to dashboard Cite

show abstract

“…There were many other series where neonates and young infants were a part of the cohort,[1517–19–2124] reporting variable outcome. Most of these series reported statistically significant improvement in saturation, similar to our data.…”

Section: Discussionmentioning

confidence: 99%

Balloon pulmonary valvotomy as interim palliation for symptomatic young infants with tetralogy of Fallot

et al. 2008

View full text Add to dashboard Cite

Objectives:To describe the case selection, technique and immediate and short-term results of balloon pulmonary valvotomy (BPV) in young infants with tetralogy of Fallot (TOF).Background:Symptomatic young infants with TOF can either undergo corrective surgery or Blalock-Taussig (BT) shunt. Corrective surgery in early infancy is associated with significant morbidity and is not a realistic option in many centers. BT shunt carries the risk of branch pulmonary artery distortion and shunt occlusion.Methods:Infants less than three months with a significant valvar pulmonary stenosis (with or without associated infundibular and annular component) and oxygen saturation ≤80% were offered BPV. The right ventricular outflow tract (RVOT) was crossed with 4F Judkin's right coronary catheter and the valve was crossed with 0.014” coronary guide wire. Serial balloon dilatations were done with over the wire coronary balloons (3-4 mm) and Mini Tyshak balloons up to a balloon annulus ratio of 2:1, depending upon the improvement in saturation and formation of annular waist.Results:Seventeen infants less than three months of age with tetralogy of Fallot (median age: 33 days, range: 10-90 days, weight: 3.47 ± 0.87 kg, pulmonary annulus Z score: -5.59 ± 1.04) including eight neonates underwent palliative BPV between May 2004 and March 2007. The mean balloon annulus ratio was 1.4 ± 0.28 and fluoroscopy time was 26.18 ± 20.2 minutes. The mean oxygen saturation increased significantly from 73 ± 7% to 90 ± 3.68% following BPV (p = 0.0001). The only major complication was RVOT perforation and pericardial tamponade in one infant. The mean follow-up period was 23 ± 12 months. Two babies developed significant desaturation requiring surgery in the six months following BPV. There was a significant increase in pulmonary annulus. The z score for the pulmonary annulus improved from -5.59 ±1.04 before BPV to - 4.31 ± 1.9 at the time of last follow-up (p = 0.018). The mean Z score of hilar right pulmonary artery (RPA) increased significantly from -1.19 ± 1.78 before BPV to 0.7 ± 0.91 after BPV (p = 0.001). The mean Z score of hilar left pulmonary artery (LPA) increased significantly from -1.28 ± 1.41 to 0.03 ± 1.29 after BPV (p = 0.005). Eight patients underwent corrective surgery.Conclusions:Balloon pulmonary valvotomy is safe and effective. It significantly improves the growth of pulmonary annulus and branch pulmonary arteries. Thus it can be considered as an interim palliative procedure for symptomatic young infants with TOF and predominant valvar pulmonary stenosis.

show abstract

“…The follow-up showed a growth of the pulmonary arteries. However, the safety and the efficacy of PTPV in severely symptomatic TOF patients, e.g., with recurrent hypoxemic spells, are still unclear [4, 5]. Although the results of primary correction of TOF in infancy are encouraging now, even with optimal conditions, young age at repair remains a risk factor [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Balloon Valvuloplasty as an Initial Palliation in the Treatment of Newborns and Young Infants with Severely Symptomatic Tetralogy of Fallot

Wang

Lee

et al. 2005

Cardiology

View full text Add to dashboard Cite

Background: Balloon valvuloplasty in infants with symptomatic tetralogy of Fallot (TOF) may increase the pulmonary flow and prompt the growth of pulmonary arteries. Method: From 1994 to 2002, percutaneous transluminal balloon valvuloplasty (PTPV) was performed in 22 consecutive newborns and young infants (<3 months of age) with TOF. The indication included severe hypoxemia (systemic oxygen saturation below 75%, 10 cases) and repeated hypoxic spells (12 cases). The age at PTPV was 8–88 days (38 ± 34, median 27) and the body weight 2–5 kg (3.45 ± 1.15, median 3). A balloon catheter (4– 7 mm in diameter and 2 cm in length) was used to dilate the pulmonary valve. Results: No major procedure-related complications occurred. The systemic oxygen saturation increased significantly (14 ± 9%). A subsequent palliative shunt operation was avoided in 12 patients (54.5%), but 10 still needed operation (median 11 days after the PTPV). The presence of recurrent hypoxic spells before PTPV was the most important indicator for PTPV failure (p = 0.02). Conclusion: PTPV was safe and effective for symptomatic newborns and young infants with TOF, but a palliative shunt operation was still needed due to short effect, especially in those with recurrent spells before the dilation.

show abstract

Early and late results and the effects on pulmonary arteries of balloon dilatation of the right ventricular outflow tract in tetralogy of Fallot

Cited by 35 publications

References 34 publications

Stenting of the right ventricular outflow tract in the symptomatic infant with tetralogy of Fallot

Stenting of the right ventricular outflow tract in the symptomatic infant with tetralogy of Fallot

Balloon pulmonary valvotomy as interim palliation for symptomatic young infants with tetralogy of Fallot

Balloon Valvuloplasty as an Initial Palliation in the Treatment of Newborns and Young Infants with Severely Symptomatic Tetralogy of Fallot

Contact Info

Product

Resources

About