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[Transluminal percutaneous pulmonary valvuloplasty. Follow up of 34 patients]
J Santos de Soto1, J Calero García, J Gavilán Camacho
1S. de Hemodinámica, Hospital Infantil, Virgen del Rocío, Sevilla.
Insights
Percutaneous transluminal valvuloplasty is a definitive treatment for pediatric pulmonary stenosis, with results improving over time. Doppler echocardiography effectively evaluates treatment outcomes, complementing electrocardiography (ECG).
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Pulmonary valve stenosis (PVS) is a significant congenital heart defect in children.
- Percutaneous transluminal valvuloplasty (PTV) is a minimally invasive treatment option for PVS.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of PTV in children with PVS.
- To assess the role of Doppler echocardiography and ECG in post-procedure patient evaluation.
Main Methods:
- Thirty-four children (2-11 years) with PVS underwent PTV.
- Patients were evaluated clinically, via chest X-ray, ECG, and 2D Doppler echocardiography at 1 month, 6 months, and 1 year post-procedure.
- Transpulmonic gradients were correlated between Doppler and manometry.
Main Results:
- PTV demonstrated immediate and sustained good results, with improvements noted over the 1-year follow-up.
- A close correlation was found between Doppler and manometry for transpulmonic gradients.
- Significant improvement in ECG findings, including disappearance of right heart hypertrophy signs, was observed.
- Twelve cases of mild pulmonary insufficiency were detected post-procedure.
Conclusions:
- PTV is considered a definitive treatment for pulmonary stenosis in children.
- 2D Doppler echocardiography is a reliable tool for evaluating PTV outcomes, reducing the need for repeat catheterization.
- ECG serves as an ideal complementary diagnostic tool alongside 2D Doppler echocardiography.
Abstract:
Thirty four children aged 2 to 11 years (means = 4.8 +/- 2.4 years) with pulmonary valve stenosis were treated by percutaneous transluminal valvuloplasty with catheter-balloon. All of them were reevaluated one month and six months after valvuloplasty, and once more year after the procedure. The evaluation consisted on clinical examination, chest Rx, ECG and Doppler 2 D-Echocardiography. We found a close correlation between transpulmonic gradients by Doppler and manometry. After pulmonary valvuloplasty we detected 12 cases of slight pulmonary insufficiency. Changes in ECG were significant since signs of right heart hypertrophy disappeared. Immediate good results got after valvuloplasty, remained and even improved throughout checking. We conclude that, faced with our results, we consider valvuloplasty as a definitive treatment of pulmonary stenosis, Doppler-two-Dimensional Echocardiography, is also useful for evaluating patients without need for a new catheterisation and EECG is an ideal complement to 2 D-Doppler Echocardiography.