Pulmonic valvular stenosis in adults: Diagnosis and treatment

Congenital Heart Diseases in Aged Patients

“…32 Patients with pulmonary valve stenosis and pulmonary artery pressure Ͼ50 -80 mm Hg should be endovascularly managed with pulmonary valvuloplasty and combined atrial septal defect transcatheter closure when an ASD is associated as in the Noonan syndrome. 33,34 These strategies seem effective, well tolerated, and very attractive in elderly patients.…”

A fatal complication arising during pulmonic balloon valvuloplasty in a seven‐month‐old female bulldog

“…The fragile and poorly compliant nature of the myocardium may have been at risk of gross rupture at the time of maximal balloon dilation when increased intraventricular pressures were generated. Additionally, at maximal balloon dilation, rapid inflation‐deflation cycles were used as this has been shown in human patients to minimise the duration of diminished cardiac output (Almeda and others 2003). At the end of CPR, echocardiography was used to rule out the presence of pericardial or pleural effusion, which may indicate pulmonary artery (PA) or RV rupture.…”

“…The reported incidence of bradycardia during ballooning was 10 per cent in one study and the treatments described included glycopyrrolate (5–10µg/kg) or atropine (20–40 µg/kg) (Ramos and others 2014). In human patients undergoing BV, transient bradycardia, premature beats and a fall in systemic blood pressure during balloon inflation have been commonly reported, but these abnormalities generally return rapidly to normal following balloon deflation (Almeda and others 2003). In patients with RV hypertrophy and reduced myocardial perfusion, even a transient disruption to blood flow and myocardial oxygen delivery may precipitate hypoxia‐induced arrhythmias.…”