In seven children with obstructed right ventricle-to-pulmonary artery conduits, balloon dilatation (BD) was performed 10-58 months after insertion of the conduit. Average valve gradient was reduced from 69 to 32 mmHg. Obstruction at the conduit-branch pulmonary artery connection became apparent after dilatation of the valve; these distal stenoses also were dilated. It is concluded that the useful lifetime of a right ventricle (RV) to pulmonary artery (PA) conduit may be extended by BD of an obstructed biological valve and/or BD of a stenotic conduit-pulmonary artery anastomosis.
This Case Report is that of a young woman followed for 21 years, whose life was saved repeatedly by bronchoscopy and lavage to remove mucous plugs and casts from the tracheobronchial tree. In 1982, after again having a respiratory crisis and not having a bronchoscopy and lavage, she died. The pathology revealed a thickened hyalinized basement membrane and numerous mucous plugs filling the larger bronchi and bronchioles.
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