Balloon Valvuloplasty via the Pulmonary Artery Trunk for Treating Neonates With Severe Pulmonary Valve Disease
DOI:
https://doi.org/10.1532/hsf.3423Keywords:
Congenital heart disease, Neonate, Critical pulmonary stenosis, Pulmonary atresia with intact ventricular septumAbstract
Background: Percutaneous balloon pulmonary valvuloplasty has proven to be a standard of care for neonates with severe pulmonary valve disease. However, the peripheral vessel injury, tricuspid chordae tendineae rupture, and cardiac tamponade could occur. Recently, we performed balloon valvuloplasty through pulmonary artery trunk. To date, the obtained outcome was promising.
Methods: Between January 2018 and December 2018, three neonates with critical pulmonary stenosis and two with membranous pulmonary atresia with intact ventricular septum were enrolled in our center. Balloon valvuloplasty through pulmonary artery trunk was performed in all patients. A 2-cm parasternal incision was made in the left third intercostal space. A guidewire was used to advance or perforate the pulmonary valve from the pulmonary artery trunk into the right ventricle, followed by balloon dilation of the valve.
Results: The procedure was successful in all patients. The oxygen saturation increased immediately after the balloon dilation, while the right ventricular systolic pressure and the gradient across the pulmonary valve decreased. No severe complications occurred.
Conclusions: Balloon valvuloplasty through the pulmonary artery trunk is a safe and feasible alternative procedure. Thus, it could serve as a supplementary choice for treating severe pulmonary valve disease.
References
Coles JG, Freedom RM, Lightfoot NE, et al. 1989. Long-term results in neonates with pulmonary atresia and intact ventricular septum. Ann Thorac Surg. 47:213-7.
Kan JS, White RI, Jr., Mitchell SE, Gardner TJ. 1982. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med. 307:540-2.
Li QZ, Cao H, Chen Q, Zhang GC, Chen LW, Chen DZ. 2013. Balloon valvuloplasty through the right ventricle: another treatment of pulmonary atresia with intact ventricular septum. Ann Thorac Surg. 95:1670-4.
Lin ZQ, Chen Q, Cao H, et al. 2017. Transthoracic Balloon Pulmonary Valvuloplasty for Treatment of Congenial Pulmonary Atresia Patients with Intact Ventricular Septum. Med Sci Monit. 23:4874-9.
Loureiro P, Cardoso B, Gomes IB, Martins JF, Pinto FF. 2017. Long-term results of percutaneous balloon valvuloplasty in neonatal critical pulmonary valve stenosis: a 20-year, single-centre experience. Cardiol Young. 27:1314-22.
McCrindle BW, Kan JS. 1991. Long-term results after balloon pulmonary valvuloplasty. Circulation. 83:1915-22.
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