Abstract
Methods and Results We retrospectively reviewed 52 young infants, 41 of whom had CPS and 11 had PA/IVS, in a single center from June 2009 to October 2017. Patients were divided into three groups according to the type of catheter used to enter through the RVOT. The unique structure of the Simmons catheter allowed it to be maneuvered directly into the RVOT within a few minutes. Compared with the other two groups, the Simmons catheter group had a significantly shorter fluoroscopy time entering through the RVOT (P < 0.001) and a shorter total X-ray exposure time (P < 0.001). Furthermore, compared with the floating catheter group, the success rate of surgery was much higher in the Simmons catheter group (P < 0.001). Conclusions The Simmons catheter is a safe and effective method to enter through the RVOT in infants with CPS or PA/IVS. Therefore, the Simmons catheter could be an alternative catheter when entering through the RVOT in young infants, especially neonates with low birth weight.
Highlights
Critical pulmonary stenosis (CPS) and pulmonary atresia with intact ventricular septum (PA/IVS) are rare and complex congenital heart defects (CHDs), accounting for approximately 3% of all CHDs [1]
Patients were divided into three groups according to the type of catheter used to enter the right ventricular outflow tract (RVOT), which were the Simmons catheter group (n 25), the floating catheter group (n 11), and the JR catheter group (n 16)
According to the Kruskal-Wallis H-test, the fluoroscopy time entering the RVOT in the Simmons catheter group was significantly lower than in the other two groups (P < 0.001)
Summary
Critical pulmonary stenosis (CPS) and pulmonary atresia with intact ventricular septum (PA/IVS) are rare and complex congenital heart defects (CHDs), accounting for approximately 3% of all CHDs [1]. Right ventricular outflow tract obstruction with various degrees of right ventricular hypoplasia is an important determinant of the management strategy [2]. PA/IVS was first managed with percutaneous balloon pulmonary valvuloplasty (PBPV) in 1990 [3]. Is technique is the predominant treatment for patients with proper anatomy suitable for transcatheter intervention in many medical centers [4, 5]. Interventional therapy for PA/IVS during the neonatal period was reported to have a high success rate, with a mid- and long-term survival rate ranging from 81.0 to 92.5% [6, 7]. The conventional approach is to enter into the right ventricular outflow tract (RVOT) in young infants. Is technique has certain difficulties and requires a long fluoroscopy time [8], especially in cases with hypoplastic right ventricle.
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