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- Title
Long-term results of percutaneous balloon valvuloplasty in neonatal critical pulmonary valve stenosis: a 20-year, single-centre experience.
- Authors
Loureiro, Petra; Cardoso, Barbara; Gomes, Inês B.; Martins, José F.; Pinto, Fátima F.; Gomes, Inês B; Martins, José F; Pinto, Fátima F
- Abstract
Introduction Percutaneous balloon valvuloplasty is the primary treatment for critical pulmonary valve stenosis in neonates. Thus far, a few studies have reported long-term results of this technique in neonatal critical pulmonary valve stenosis.<bold>Methods: </bold>We carried out a retrospective study of all consecutive newborns with critical pulmonary valve stenosis subjected to percutaneous balloon valvuloplasty at a single centre, between 1994 and 2014, to assess its immediate and long-term safety and efficacy.<bold>Results: </bold>A total of 24 neonates presented with critical pulmonary valve stenosis. The mean diameter of the pulmonary annulus was 7 mm (±1.19); 33.3% had a dysplastic pulmonary valve, and 92% were started on prostaglandin E1 treatment. Percutaneous balloon valvuloplasty was performed at a mean age of 4.0±4.3 days using, on average, a balloon-to-pulmonary annulus ratio of 1.18 mm (with a range from 0.9 to 1.43). Immediate success was achieved in 22/24 patients (92%) with a reduction in the pulmonary transvalvular peak gradient (p<0.05) and in the right ventricle/systemic pressure ratio (p<0.05). There was one death (4%) 6 days after the procedure, and 29.2% of them had transient rhythm complications. For a mean follow-up time of 8.4 years, the re-intervention rate was 42.9%. In total, 14 re-interventions were performed in nine neonates, including surgery in six. Freedom from re-intervention was 50% at 8 years and 43% at 10 and 15 years.<bold>Conclusion: </bold>This series, to the best of our knowledge, has had the longest follow-up of neonates with critical pulmonary valve stenosis. Percutaneous balloon valvuloplasty is a safe and effective treatment, and in our study 75% of the patients were exclusively treated using this technique.
- Subjects
PORTUGAL; PERCUTANEOUS balloon valvuloplasty; PULMONARY valve stenosis in children; NEONATAL diseases; PATENT ductus arteriosus; CONGENITAL heart disease; PULMONARY atresia; CATHETERIZATION; LONGITUDINAL method; PULMONARY stenosis; TIME; SPECIALTY hospitals; TREATMENT effectiveness; RETROSPECTIVE studies; KAPLAN-Meier estimator; THERAPEUTICS
- Publication
Cardiology in the Young, 2017, Vol 27, Issue 7, p1314
- ISSN
1047-9511
- Publication type
journal article
- DOI
10.1017/S1047951117000178