Valvuloplastia pulmonar en menores de 21 años

Abstract

MotivationTo determine the association between the proportion of reoperations in patients with pulmonary valvular stenosis and the presence of a final pulmonary transvalvular gradient of ≥25mm Hg in patients under the age of 21. MethodsObservational single-centre study, cross-sectional period type. PopulationPatients between 0 months and 21 years of age who underwent balloon pulmonary valvuloplasty. AnalysisDescription of the group and analysis in the subgroups given by the final transvalvular gradient of ≥25mm Hg and reoperation. Pearson's chi-squared test was conducted for categorical variables. For the continuous variables, the Mann–Whitney U test was conducted. Logistic regression was used to define the association between variables and reoperation outcome. ResultsIn the group with the final gradient of ≥25mm Hg, 86.67% were infants. The group with the final gradient of<25mm Hg the median of the initial gradient was 42mm Hg IQ 25-75%: (34-59) in comparison to the group with the final gradient ≥25mm Hg, the median of the initial gradient was 70mm Hg IQ 25-75%: (41-86). By analysing both groups with the reoperation variable, it was observed that the change in the relationship of the pressured between the right ventricle and the left ventricle was associated with a lower need for reoperation. OR 0.04; CI 95% (0.002-0.7). Having a final gradient of ≥25mm Hg after the surgery was associated to reoperation. OR 14.5; CI 95% (2.8-75). ConclusionHaving a final pulmonary transvalvular gradient of ≥25mm Hg was associated to a higher probability of reoperation.