Balloon pulmonary valvuloplasty: A Review

Rao, P. Syamasundar

doi:10.1002/clc.4960120202

Cited by 69 publications

(59 citation statements)

References 72 publications

(36 reference statements)

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“…[1][2][3] Although it was first described in the 1980s, 4 pulmonary balloon valvuloplasty (PBV) is still a common procedure used for the treatment of PS in humans [4][5][6][7][8][9] and dogs.…”

mentioning

confidence: 99%

Prospective Evaluation of the Balloon‐to‐Annulus Ratio for Valvuloplasty in the Treatment of Pulmonic Stenosis in the Dog

Estrada

Moı̈se

Erb

et al. 2006

Veterinary Internal Medicne

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Background: In dogs, treatment of pulmonic valve stenosis (PS) with pulmonary balloon valvuloplasty (PBV) is a viable method to decrease the pressure gradient across the valve. However, to the authors' knowledge, the variables that influence the selection of the correct balloon size for the procedure have not been explored. Moreover, the lesions caused by the procedure have not been detailed.Hypothesis: Variables that influence the measurement of the annulus could affect selection of the balloon size. We sought to determine the effects of treatment when the balloon-to-annulus ratio (BAR) was or .1.3, but within the recommended range of 1.2-1.5, regardless of whether dilation was performed with single or double balloon technique.Animals: Twenty-five Beagles with PS were studied. Methods: Inter-and intra-observer variability, echocardiography versus angiocardiography, and systolic versus diastolic timing were evaluated for the BAR. Assessment of right ventricular (RV) pressure, Doppler gradient, stenotic valve area, and RV wall thickness were compared before and 1, 90, and 180 days after treatment. Postmortem examination of the heart was done.Results: Significant correlations existed in measurement of the annulus; however, variation existed that would change balloon size. Improvement in the degree of PS was significant regardless of the BAR or single or double ballooning. In the most severely affected dogs, continued improvement was noted on day 90. Postmortem examination revealed tears in the commissures and the valve leaflets.Conclusions: Multiple factors influenced determination of the BAR and a range of 1.2-1.5 was effective without detrimental consequences. Dogs with severe PS had continued decrease in RV pressure 3 months after treatment.

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mentioning

confidence: 99%

Prospective Evaluation of the Balloon‐to‐Annulus Ratio for Valvuloplasty in the Treatment of Pulmonic Stenosis in the Dog

Estrada

Moı̈se

Erb

et al. 2006

Veterinary Internal Medicne

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“…Ray et al [9] also did not find the balloon size to be pre dictive of the period immediately following dilatation and those during follow-up. [4,5,10] has reported the effect of the BAR on both immediate and intermediate-term outcome of PBV. He studied 64 dilatation procedures in 56 patients and compared patients in whom the BAR was less than or equal to 1.0 with those in whom it was greater than 1.0.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Balloon-Anulus Ratio on the Intermediate and Follow-Up Results of Pulmonary Balloon Valvuloplasty

et al. 1997

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Pulmonary balloon valvuloplasty (PBV) is an effective method to treat congenital valvular pulmonic stenosis, but the ideal balloon-anulus ratio (BAR) for this procedure remains unclear. We studied 71 procedures where BARs of 1.0-1.5 were used, since it has been shown that a ratio of < 1.0 is less effective and that of > 1.5 may produce more complications. A curvilinear relation was found between BAR and the fractional fall in haemodynamic parameters reflecting stenosis severity, both immediately after dilatation and at follow-up. Best results were observed with a BAR of 1.25, with progressive worsening on either side of this ratio. The relationship remained significant in multiple regression analysis involving age, sex and baseline haemodynamic variables. The data show that a BAR of 1.25 is probably the ideal ratio for PBV.

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“…Bu oranın üzerinde olursa infindibuler spazma ve pulmoner kapak yetmezliğine, hatta kapakta zedelenmeye neden olabilir. Eğer bu oran düşük olur yani küçük çaplı balon kullanılırsa işlemin başarısız olma ihtimali artar (1,3,7,8,(17)(18)(19). Çalışmamızdaki hastalarda balon/anülüs çap oranı ortalaması 1.21 (1.1-1.33) olarak hesaplandı.…”

Section: Resim 4: Hastanın Tele Görüntüsünde Pulmoner Konus Belirgin unclassified

“…Eğer hastada ağır pulmoner kapak yetmezliğiyle birlikte kalp yetmezliği kliniği de varsa komplikasyon gelişme ihtimali daha yüksektir. Pulmoner balon valvüloplasti işlemine bağlı oluşabilen komplikasyonlar arasında pulmoner kapak yetmezliği, kapağın ve anülüsün yırtılması, pulmoner arter zedelenmesi, triküs-pit kapak zedelenmesi ve yetmezliği, infektif endokardit, aritmiler, kanama ve tromboz, kardiyak tamponat, bradikardi ve hipotansiyon sayılabilir (1,3,8,11,12,17,19,(21)(22)(23). Bizim çalışmamızda bulunan hastalarda işlemden sonra ve kontrollerde önemli bir komplikasyon gelişmedi-ği, dört hastada (%30) EKO ile tespit edilen, klinik olarak anlamlı olmayan hafif pulmoner kapak yetmezliği gelişti-ği, zamanla artmadığı görüldü.…”

Section: Resim 4: Hastanın Tele Görüntüsünde Pulmoner Konus Belirgin unclassified

Pulmoner balon valvüloplasti yapılan çocuklarda kalp kateterizasyonu sonuçlarının değerlendirilmesi

Çimen¹,

Arslan²,

Aslan³

et al. 2014

GenelTipDer

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Amaç: Bu çalışmada, çocuk kardiyoloji kliniğimizde üç yıl boyunca pulmoner balon valvüloplasti işlemi yapılan çocuklarla ilgili klinik deneyimlerimizin paylaşılması ve sonuçlarının değerlendirilmesi amaçlandı . Gereç ve yöntem: Bu retrospektif çalışmaya, Kasım 2010-Kasım 2013 tarihleri arasında pulmoner balon valvüloplasti işlemi uygulanmış olan çocuklar dahil edildi. Hastalardan sendromik olan yoktu. Pulmoner balon valvüloplasti işlemi, hastalar kateterizasyon laboratuarında genel anestezi altında entübe edilerek gerçekleştirildi. Bulgular: Çalışmaya yedisi kız, altısı erkek 13 hasta dahil edildi. Hastaların ortalama yaşı 2.9±3.74 yıl, yaş aralığı dört günlük-10 yaş arasında idi. Pulmoner darlık 10 hastada valvüler tipte olmasına karşılık, üç hastada valvüler ve infundibuler darlık birlikteydi. İşlemde monofoil kateterler kullanıldı, kateterlerin ortalama çapı 12.2 mm (6-20 mm) idi. Balon/anülüs çap oranı ortalaması 1.21 (1.1-1.33) olarak hesaplandı. Kalp kateterizasyonu sırasında pulmoner kapak üzerinde ölçülen basınç gradiyenti, işlem öncesinde ortalama 75 mmHg (40-120 mmHg), işlem sonrasında ise ortalama 36.4 mmHg (0-95 mmHg) olarak ölçüldü. Hastalara ortalama üç kere (2-5) dilatasyon yapıldı. Hastalardan dördünde darlık gradiyentinde anlamlı bir düşüş olmadığı için hastalar operasyona verildi, bir hastaya ise takiplerinde rezidü darlık geliştiğinden dolayı ikinci kere balon valvüloplasti işlemi yapıldı. Dört hastada (% 30) hafif pulmoner yetmezlik tespit edildi, başka majör veya minör bir komplikasyon gelişmedi. Sonuç: Pulmoner balon valvüloplasti işlemi, pulmoner kapak darlıklarında, her yaştaki hastada ilk tedavi seçeneğidir. Güvenli ve etkili bir işlemdir. Balon/anülüs çap oranı 1.2-1.4 arasında olursa; başarı şansı daha yüksek ve komplikasyon gelişme ihtimali daha düşüktür. Anahtar sözcükler: Pulmoner darlık, pulmoner balon valvüloplasti, klinik sonuçlarEvaluation of the results of cardiac catheterization in children who underwent pulmonary balloon valvuloplasty Objectives: In this study, we aimed to share our clinical experience and evaluate the results of the pulmonary balloon valvuloplasty procedure in patients who attended our pediatric cardiology department fot the last three years. Matherial and methods: The patients who underwent pulmonary balloon valvuloplasty procedure between November 2010 and November 2013 have been included this retrospective study. There were no syndromic patients. The pulmonary balloon valvuloplasty procedure was performed by intubating the patients under general anesthesia in the catheterization laboratory. Results: Seven girls and six boys have been included this study. The mean age was was 2.9±3.74 years and the patients aged between four days and 10 years-old. There were valvular type pulmonary stenosis in ten patients, valvular and infundibular type pulmonary stenosis in three patients. Monofoil catheters were used for the procedure and the average diameter of the catheter was 12.2 mm (6-20 mm). Balloon/anulus diameter ratio was 1.21 (1.1-1.33). During cardiac cathete...

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Balloon pulmonary valvuloplasty: A Review

Cited by 69 publications

References 72 publications

Prospective Evaluation of the Balloon‐to‐Annulus Ratio for Valvuloplasty in the Treatment of Pulmonic Stenosis in the Dog

Prospective Evaluation of the Balloon‐to‐Annulus Ratio for Valvuloplasty in the Treatment of Pulmonic Stenosis in the Dog

Effect of the Balloon-Anulus Ratio on the Intermediate and Follow-Up Results of Pulmonary Balloon Valvuloplasty

Pulmoner balon valvüloplasti yapılan çocuklarda kalp kateterizasyonu sonuçlarının değerlendirilmesi

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