Balloon valvuloplasty via right ventricle pulmonary valve for the treatment of pulmonary atresia with intact ventricular septum in children

Abstract

Objective To evaluate the early outcomes of balloon valvuloplasty via right ventricle pulmonary valve for the treatment of pulmonary atresia with intact ventricular septum in children.Methods Methods Between January 2010 and December 2010, 6 patients were diagnosed with pulmonary atresia with intact ventricular septum, and underwent balloon valvuloplasty via right ventricle pulmonary valve at this center. Of the 6 patients, the mean body weight was 3. 8 ± 1.6 kg, the mean transcutaneous oxygen saturation was 71 ± 10%, and the mean age was 56 ± 45 days. All of the 6 patients had tripartite right ventricles. Their tricuspid valve z-scores ranged from -2 to 2. 2 (mean zscore: 0. 4 ± 1. 5). Results During operation, the mean size of the balloons used was 7. 3 ± 1. 2 mm,the ratio of the balloon size to pulmonary valve ring was 1.0 ± 0. 1, the pressure gradient between right ventricle and main pulmonary artery was 19 ± 11 mmHg, the ratio of forward flow from right ventricle to that from ductus arteriosus was 0. 35 ± 0. 06. After surgery, the mean ventilation time was 3. 2 ± 1.0 days, and mean ICU stay was 16 ± 5 days. The post-operative transcutaneous oxygen saturation was 89 ± 5%. The patients were followed up for 4 ± 3. 6 months. No death and post-operative complications were noted. One patient underwent interventional balloon valvuloplasty 2 weeks after the first surgery. The transcutaneous oxygen saturation on last follow-up was 85 ± 6%, which was significantly improved after surgery (t = -2. 66, p = 0. 045). The postoperative pressure gradient between right ventricle and main pulmonary artery was 45 ± 42 mmHg. Four of the 6 patients had pulmonary regurgitation, 3 of whom were mild and 1 was moderate. Tricuspid valve z-scores (mean, 0. 5± 1) also improved compared with that before procedure (t = -3. 36, p = 0. 02). Conclusions Balloon valvuloplasty via right ventricle pulmonary valve is safe and effective to treat the pulmonary atresia with intact ventricle septum in children. Key words: Pulmoanry atresia; Heart disease, congenital; Dilatation