Hybrid treatment of pulmonary atresia with intact ventricular septum and critical pulmonary stenosis in neonates

Abstract

Objective To investigate the outcomes of hybrid treatment of pulmonary valve's balloon valvuloplasty via right ventricle without cardiopulmonary bypass for pulmonary atresia with intact ventricular septum(PA/IVS) and critical pulmonary stenosis(PS) in neonates. Methods The clinical features and data of 3 children(1 case of PA/IVS and 2 cases of critical PS), who underwent hybrid treatment of balloon valvuloplasty, were recorded and retrospectively analyzed.All patients' right ventricle grow well, tricuspid valve Z score >-2, and underwent pulmonary valve balloon valvuloplasty via right ventricle without cardiopulmonary bypass. Results All the 3 children underwent pulmonary valve balloon valvuloplasty via right ventricle without cardiopulmonary bypass, and there was no death. The mean arterial blood oxygen saturation after operation went up, and there was no complication related to balloon valvuloplasty.The children were followed up for 3 to 6 months, and all the patients had mild pulmonary stenosis, but they did not need any treatment. Conclusions Pulmonary valvuloplasty with hybrid technique is effective in treatment of selective PA/IVS children(fused leaflets of pulmonary valve) and critical PS in neonates.Hybrid therapy may provide adequate pulmonary blood flow and promote further growth of tricuspid valve and right ventricular cavity with less trauma and more safety. Key words: Pulmonary atresia with intact ventricular septum; Pulmonary stenosis; Hybrid approach; Balloon dilation