Right Ventricular Growth and Function After Balloon Valvuloplasty for Critical Pulmonary Valve Stenosis in Infants...

Area of Science:

• Pediatric Cardiology
• Echocardiography
• Congenital Heart Disease

Background:

• Critical valvular pulmonary stenosis (PS) in neonates and infants poses challenges for right ventricular (RV) development.
• Limited data exist on RV growth and function post-balloon pulmonary valvuloplasty (BPV) for critical PS.

Purpose of the Study:

• To evaluate the changes in RV growth and function in neonates and infants following BPV for critical valvular PS.
• To assess RV structural and functional recovery over a one-year follow-up period.

Main Methods:

• Prospective study of 41 neonates and infants with isolated critical valvular PS undergoing BPV.
• Serial echocardiographic examinations performed before, and at 1 week, 1 month, 3 months, 6 months, and 1 year after BPV.
• Assessment of RV dimensions, wall thickness, annular diameters, pulmonary pressures, and diastolic/systolic function indices (RV Tei index, tricuspid annular systolic velocity, RV E/A ratio).

Main Results:

• Significant reduction in RV systolic pressure and transvalvular gradient within 1 week post-BPV.
• Increased RV end-diastolic dimension and pulmonary/tricuspid valve annulus diameters over 1 year.
• Decreased RV anterior wall thickness.
• Significant improvement in RV systolic and diastolic function, evidenced by reduced RV Tei index, increased tricuspid annular systolic velocity, and improved RV E/A ratio.
• Catch-up growth of RV structures observed after 6 months post-BPV.

Conclusions:

• BPV leads to significant improvements in RV growth and function in infants and neonates with critical PS.
• The procedure facilitates RV structural remodeling and functional recovery, with catch-up growth evident by 6 months.
• Echocardiography is crucial for monitoring RV adaptation after BPV in this population.