Related Experiment Video
Updated: Jul 18, 2026
07:41
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Pulmonary atresia with intact ventricular septum: initial management
Kelly M McLean1, Jeffrey M Pearl
1Division of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
The Annals of Thoracic Surgery
|November 28, 2006
Summary
Catheter-based therapy for pulmonary atresia with intact ventricular septum rarely avoids surgery. Most infants still require surgical intervention for pulmonary blood flow, highlighting the need for further management strategies.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Interventional Cardiology
Background:
- Pulmonary atresia with intact ventricular septum (PAIVS) presents suboptimal outcomes.
- Initial management strategies for PAIVS are debated.
- This study evaluates catheter-based therapy's impact on early surgical intervention needs.
Purpose of the Study:
- To assess the efficacy of catheter-based interventions in neonates with PAIVS.
- To determine if catheter-based therapy reduces the necessity for early surgical procedures.
- To analyze outcomes following catheter-based interventions in PAIVS patients.
Main Methods:
- Retrospective chart review of 25 neonates with PAIVS (1999-2005).
- Analysis of initial interventions: catheter-based therapy vs. operative procedures.
- Evaluation of technical success, complications, and subsequent surgical requirements.
Main Results:
- 56% of patients initially received catheter-based therapy (valvotomy).
- Adequate valvotomy achieved in 79%, but 64% required surgery post-catheterization.
- Only 36% weaned from prostaglandins without surgery; 3 of 23 treated patients avoided infancy operation.
Conclusions:
- Balloon valvotomy for PAIVS seldom eliminates the need for surgical pulmonary blood flow.
- Additional procedures like shunts or stenting are frequently required post-catheterization.
- Catheter-based therapy alone is insufficient to obviate surgical intervention in most PAIVS cases.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:27Mitral Stenosis IV: Nursing Management
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...