Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-25T23:14:15.308Z Has data issue: false hasContentIssue false
  • English
  • Français

Experience with balloon pulmonary valvuloplasty and predictors of outcome: a ten-year study

Published online by Cambridge University Press:  19 February 2020

Sonia A. El-Saeidi ,
Hala S. Hamza ,
Hala M. Agha ,
Mohammed M. Soliman ,
Wael A. Attia Open the ORCID record for Wael A. Attia [Opens in a new window] ,
Rania El-Kaffas ,
Faten Abdel-Aziz ,
Osama Abdel-Aziz ,
Sahar Shaker  and
Amira Esmat
...Show all authors
Sonia A. El-Saeidi
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Hala S. Hamza
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Hala M. Agha
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Mohammed M. Soliman
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Wael A. Attia*
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Rania El-Kaffas
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Faten Abdel-Aziz
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Osama Abdel-Aziz
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Sahar Shaker
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Amira Esmat
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Rasha Ammar
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Aya Fattouh
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Khalid Mohi-eldin
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Amal M. El-Sisi
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
*
Author for correspondence: W. Attia, Paediatric Department, Cardiology Division, Cairo University, 1 Ali Ibrahim Street, Alsayeda Zainab, Cairo, Egypt. Tel: +20201111927252. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Balloon pulmonary valvuloplasty is the treatment of choice for patients with moderate to severe pulmonary valve stenosis.

Methods:

An observational retrospective cross-sectional study including neonates, small infants, and children who underwent balloon pulmonary valvuloplasty in the period from 2007 to 2016 in the cardiac catheterisation unit of the paediatric cardiology department in Cairo University. Multivariable models were built to report the predictors of the outcome of balloon pulmonary valvuloplasty and its complications.

Results:

A total of 1200 patients were included in the study and divided according to age into 3 groups: neonates and early infants (n = 282), infants (n = 362), and children (n = 556). Procedural success, defined as a drop pressure gradient across the pulmonary valve to less than or equal to 50% of the baseline measurements, was achieved in 82.7% of the patients. Multivariate analysis revealed that only infundibular pulmonary stenosis (p value 0.032), supravalvular in association with valvular pulmonary stenosis (p value <0.001), and pulmonary valve diameter by angiogram (p value <0.001) were significant predictors of success. The presence of supravalvular in association with valvular pulmonary stenosis (p value <0.001) was associated with a lower weight (p value 0.007) and higher right ventricular pressure before the intervention (p value <0.001), and a minor immediate drop in the pressure gradient post-intervention (p value <0.001) was found to be the most significant predictor of the occurrence of complications.

Conclusion:

The absence of infundibular and supravalvular stenosis and a large pulmonary valve diameter were the most significant predictors of success.

Keywords

Valvular pulmonary stenosispercutaneousballoon valvuloplasty
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 4 , April 2020 , pp. 482 - 488
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Rocchini, AP, Beekman, RH, Shachar, GB, Benson, L, Schwartz, D, Kan, JS. Balloon aortic valvuloplasty: results of valvuloplasty and angioplasty of congenital anomalies registry. AmJ Cardiol 1990; 65: 784–789.CrossRefGoogle ScholarPubMed
Khan, MA, Youssef, SA, Mullins, CE. Percutaneous transluminal balloon pulmonary valvuloplasty for the relief of pulmonary valve stenosis with special reference to double-balloon technique. Am Heart J 1986; 12: 158–166.10.1016/0002-8703(86)90695-2CrossRefGoogle Scholar
Rao, PS. Percutaneous balloon pulmonary balloon valvuloplasty: state of the art. Catheter Cardiovasc Interv 2007; 69: 747–763.CrossRefGoogle ScholarPubMed
Saad, M, Roushdy, A, Elsayed, M. Immediate -and medium- term effects of balloon pulmonary valvuloplasty in infants with critical pulmonary stenosis during the first year of life. J Saudi Heart Assoc; 2010: 22: 195–201.CrossRefGoogle ScholarPubMed
Lock, JE. Evaluation and management prior to catheterization. In: Lock, JE, Keane, JF, Perry, SB (eds). Diagnostic and Interventional Catheterization in Congenital Heart Disease, 2nd edn. Kluwer Academic Publisher, Boston, 2000: 1–12.10.1007/978-1-4757-3173-6CrossRefGoogle Scholar
Cheatham, JP. Pulmonary stenosis. In: Park, MK, Troxler, RG (eds). Pediatrics Cardiology for Practitioners, 4th edn. Mosby, St. Louis, 1998: 1207–1256.Google Scholar
Bridges, ND, O’Laughlin, MP, Mullins, CE, et al.Cardiac catheterization, angiography and intervention. In: Allen, HD, Clark, EB, Gutgessell, HP, et al. (eds). Moss and Adams’ Heart Disease in Infants, Children and Adolescents, 6th edn. Lippincott Williams and Wilkins, Philadelphia, 2001: 276–324.Google Scholar
Botto, LD, Correa, A, Erickson, JD. Racial and temporal variations in the prevalence of heart defect. Pediatrics 2001; 107: 1.CrossRefGoogle Scholar
Holzer, RJ, Gauvreau, K, Kreutzer, J, et al.. Safety and efficacy of balloon pulmonary valvuloplasty: a multicenter experience. Catheter Cardiovasc Interv 2012; 80: 663–672.10.1002/ccd.23473CrossRefGoogle ScholarPubMed
Ghaffari, S, Ghaffari, MR, Ghaffari, AR, Sgafy, S. Pulmonary valve balloon valvuloplasty compared across three age groups of children. Int J Gen Med 2012; 5: 479–482.CrossRefGoogle ScholarPubMed
Behjati, M, Seyed, M, Shahrokh, R. Long-term results of balloon pulmonary valvuloplasty in children with congenital pulmonary valve stenosis. Iran J Pediatr 2013; 23: 32–36.Google Scholar
Gielen, H, Daniels, O, van Lier, H. Natural history of congenital pulmonary valvar stenosis: an echo and Doppler cardiographic study. Cardiol Young 1999; 9: 129–135.10.1017/S1047951100008337CrossRefGoogle ScholarPubMed
Handoka, NM, El-Eraky, AZ. Predictors of successful pulmonary balloon valvuloplasty in infants with severe pulmonary valve stenosis. Egypt Heart Mirror J 2007; 1: 66–74.Google Scholar
Ahmadi, A and Sabri, M. Percutaneous Balloon Valvuloplasty in patients with Pulmonary Valve Stenosis. J Pak Med Assoc 2012; 62: S58–S61.Google ScholarPubMed
Liu, F, Wu, L, Huang, GY, et al.Percutaneous balloon valvuloplasty for severe and critical pulmonary valve stenosis in infants under six months. Zhonghua Yi Xue Za Zhi 2009; 89: 3253–3256.Google ScholarPubMed
Jaing, TL, Hwang, B, Lu, JH, Hsieh, KS, Meng, CC. Percutaneous balloon valvuloplasty in severe pulmonary valvular stenosis. Angiology 1995; 46: 503–509.CrossRefGoogle ScholarPubMed
Larry, A. Critical pulmonary stenosis. J Interven Cardiol 2001; 14: 345–350.Google Scholar
Peterson, C, Schilthuis, JJ, Dodge-Khatami, A, Hitchcock, JF, Meijboom, EJ, Bennink, GB. Comparative long-term results of surgery versus balloon valvuloplasty for pulmonary valve stenosis in infants and children. Ann Thorac Surg 2003; 76: 1078–1083.CrossRefGoogle ScholarPubMed
Tggart, NW, Cetta, F, Cabalka, Ak, Hagler, DJ. Outcomes for balloon pulmonary valvuloplasty in adult. Catheter Cardiovasc Interv 2013; 82: 811–815.Google Scholar
Bernstein, D. Acyanotic congenital heart disease: the obstructive lesions. In: Behrmen, RE, Kliegman, RM, Jenson, HB (eds). Nelson Textbook of Pediatrics, 17th edn. W.B. Saunders Co., Philadelphia, 2004: 1513–1515.Google Scholar
Mendelsohn, AM, Banerjee, A, Meyer, RA, Schwartz, DC. Predictors of successful pulmonary balloon valvuloplasty: 10-year experience. Cathet Cardiovasc Diagn 1996; 39: 236–243.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
McCrindle, BW. Independent predictors of long-term results after balloon pulmonary valvuloplasty. Valvuloplasty and Angioplasty of Congenital Anomalies (VACA) Registry Investigators. Circulation 1994; 89: 1751–1759.CrossRefGoogle ScholarPubMed
Silvilairat, S, Pongprot, Y, Sittiwangkul, R, Phornphutkul, C. Factors determining immediate and medium-term results after pulmonary balloon valvuloplasty. J Med Assoc Thai 2006; 89: 1404–1411.Google ScholarPubMed