Balloon Valvuloplasty for Pulmonary Stenosis in Children: Immediate Outcome and Cardiac Remodeling during Midterm Follow-up

Amoozgar, Hamid; Salehi, Mina; Borzoee, Mohammad; Ajami, Gholamhossein; Edraki, Mohammad Reza; Mehdizadegan, Nima; Mohammadi, Hamid

doi:10.5812/ijp.10058

Cited by 8 publications

(4 citation statements)

References 22 publications

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“…M-mode, two-dimensional, Doppler, and Color-Doppler transthoracic echocardiography procedures were performed before, as well as immediately and every 6 months after the interventions using a 2 -4 Hz HS70 probe made by Samsung Co. (South Korea) (13,14). The procedures were performed by pediatric interventional cardiologists.…”

Section: Methodsmentioning

confidence: 99%

Results of Transcatheter Therapy with Balloon Versus Stent for Treating Isolated Branch Pulmonary Artery Stenosis in Children and Adolescents: A Midterm Study

Edraki,

Ataei,

Mehdizadegan

et al. 2023

Iran J Pediatr

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Background: Branch pulmonary artery stenosis presents as either an isolated disease or in association with congenital heart diseases (in 2 - 3% of cases). Balloon angioplasty (BA) and stent implantation (SI) are two percutaneous methods that are commonly used to treat this condition. We compared the outcomes of these 2 methods in children and adolescents with isolated branch pulmonary artery stenosis. Methods: Pediatric patients with severe branch pulmonary artery stenosis who were referred to our center and underwent transcatheter insertion via either BA or SI between 2010 and 2019 were studied. Patients’ demographic data, including age, gender, and body weight, were recorded. Standard procedures for BA and SI were applied. Post-procedure angiography and echocardiographic parameters were determined and compared between the 2 groups. Patients who were followed up for at least 2 years were selected for this study, and comparative evaluations were performed during the follow-up. Results: Forty patients with a median age of 2.1 years and a median weight of 10 kg were enrolled in the study, of whom 25 and 15 underwent BA and SI, respectively. The trans-stenotic pulmonary artery pressure gradient significantly reduced immediately after both procedures, but there was no significant difference between the BA and SI groups in terms of pulmonary artery pressure gradient early after the procedures (P-value = 0.014). There was a significant decline in the peak right ventricular pressure after both procedures. Restenosis occurred more frequently in the BA group. In the BA group, patients under one year old and weight lower than 10 kg had a lower restenosis recurrence rate, evidenced by echocardiographic measurements, compared to those with a weight over 10 kg. Three patients (12%) in the BA group needed balloon reinsertion. Conclusions: Immediate therapeutic success was similar between BA and SI in patients with branch pulmonary artery stenosis. Re-stenosis occurred more often in the BA group; however, the chance of re-stenosis was lower among patients weighing less than 10 kg over a 2-year follow-up.

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Section: Methodsmentioning

confidence: 99%

Results of Transcatheter Therapy with Balloon Versus Stent for Treating Isolated Branch Pulmonary Artery Stenosis in Children and Adolescents: A Midterm Study

Edraki,

Ataei,

Mehdizadegan

et al. 2023

Iran J Pediatr

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“…The echocardiographic data were extracted according to the American Society of Echocardiography (ASE) standards in fourchamber, subcostal, and suprasternal views 17,18 to determine the superior vena cava (SVC) and right upper pulmonary vein pressure gradients. An average of three mean pressure gradients in the mentioned echocardiographic views was measured, and the mean value was calculated for analysis to decrease interobserver variability.…”

Section: Methodsmentioning

confidence: 99%

Minimally invasive versus sternotomy approach for double‐patch repair of partial anomalous pulmonary venous connection and sinus venosus defect in pediatric and adult patients: Mid to long‐term outcomes

Amirghofran

Nirooei

Edraki

et al. 2022

Journal of Cardiac Surgery

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Background Several surgical techniques have been proposed to repair right partial anomalous pulmonary venous connection (PAPVC) along with sinus venosus defect (SVD). This study aimed to compare the perioperative data and outcomes of double‐patch repair using a minimally invasive approach versus conventional sternotomy in pediatric and adult patients. Methods This retrospective study was conducted on 48 minimally invasive cases and 35 sternotomy cases, undergoing surgery by a single surgeon between July 2002 and August 2020. For all patients, repair was performed using the double‐patch technique. In the minimally invasive approach, right mini‐thoracotomy was performed with central cannulation for children and with peripheral cannulation for adults. The patients were classified into two pediatric and adult groups, and each group was categorized into minimally invasive and sternotomy approaches. They were followed‐up by transthoracic echocardiography and electrocardiography before and early after surgery, 3 and 6 months after surgery, and then annually. The relative data were compared between the two approaches in terms of perioperative findings, postoperative pulmonary vein or superior vena cava (SVC) stenosis, and sinus node dysfunction. Results This study included 25 minimally invasive cases and 19 sternotomy cases in the pediatric group (mean age, 4.99 ± 4.28 and 6.10 ± 4.39 years, respectively) and 23 minimally invasive cases and 16 sternotomy cases in the adult group (mean age, 35.73 ± 8.06 and 32.62 ± 9.80 years, respectively). The mean and median follow‐ups were 6.31 ± 4.92 years and 6 years (range: 6 month−18 year) in the pediatric group and 6.15 ± 4.53 years and 5 years (range: 6 month−18 year) in the adult group, respectively. The mean chest tube drainage was significantly lower in the minimally invasive pediatric group (p = .03), and the mean blood transfusion volume was significantly lower in the minimally invasive adult group compared to the other groups (p = .03). No stenosis occurred in the pulmonary veins. Mild SVC stenosis occurred in one patient in the minimally invasive pediatric group, with no need for reintervention. All patients had a normal sinus rhythm, except for the mentioned case with a transient, first‐degree atrioventricular block, which spontaneously reverted to the normal sinus rhythm. Conclusions The minimally invasive approach can be a safe and practical alternative for the double‐patch repair of PAPVC and SVD. It ensures a repair with comparable quality to sternotomy, but with better cosmetic and psychological outcomes.

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“…Parent et al (26) encontraron una disminución en la gradiente de 10 mmHg a los 5 años. Amoozgar et al (27) en su estudio en Irán encontraron que la disminución significativa de estenosis pulmonar con la presión de VD después de procedimiento y en el seguimiento, la gradiente de la presión se mantiene en límites aceptables. En esta serie se completó en 28 pacientes un seguimiento de 5 años, los cuales reportan una gradiente final de 17 mmHg.…”

Section: Gradiente Pulmonar Previo Y Posterior Al Procedimientounclassified

Resultados de la valvuloplastia percutánea con balón en la estenosis valvular pulmonar en población pediátrica en el Instituto Nacional Cardiovascular – INCOR, Lima – Perú

Huamán-Benancio

Peralta-Ponce

Vinelli-Arzubiaga

et al. 2022

Arch Peru Cardiol Cir Cardiovasc

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Objetivo. Evaluar la efectividad de la valvuloplastia percutánea con balón (VPB) en estenosis valvular pulmonar (EP) en pediatría y sus resultados durante el seguimiento. Métodos. Se estudiaron 80 pacientes con EP a quienes se les realizaron VPB entre enero de 2014 y diciembre de 2019. Las características demográficas, ecocardiográficas y hemodinámicas del procedimiento se detallan a través de una estadística descriptiva en tanto que en el seguimiento se utilizó pruebas estadísticas paramétricas y no paramétricas con relación a insuficiencia pulmonar y reestenosis. Resultados. El rango de edad fue de 2 años (rango intercuartil RIQ 10,5 - 72 meses), el sexo predominante fue masculino con 56,2%. La gradiente transvalvular pulmonar disminuyó de 61,7 ± 21,2 mmHg a 17 mmHg (RIQ: 11 - 26 mmHg). La tasa de éxito inmediato de la VPB se situó en el 90%. La mediana del tiempo de seguimiento fue de 21 meses (RIQ: 5-47,5 meses). Todos los pacientes en el seguimiento mostraron algún grado de insuficiencia pulmonar en cada punto de corte, en el 17% de los casos al final de su seguimiento se encontró insuficiencia severa. Se encontró tres casos de reestenosis a largo plazo (3,8%) y 6 casos (7,5%) que ingresaron a sala de operaciones para plastia o recambio valvular pulmonar. Las complicaciones reportadas alcanzaron 10% de casos, de los cuales dos pacientes ingresaron a cirugía durante el procedimiento por complicaciones mayores. Se encontró asociación significativa con insuficiencia pulmonar severa al final del seguimiento y la relación anillo/balón. Conclusiones. La VPB es una técnica efectiva en el tratamiento de la estenosis valvular pulmonar, con complicaciones reportadas, pero con buenos resultados durante el seguimiento.

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Balloon Valvuloplasty for Pulmonary Stenosis in Children: Immediate Outcome and Cardiac Remodeling during Midterm Follow-up

Abstract: Background: Percutaneous balloon pulmonary valvuloplasty (BPV) is treatment of choice for valvular pulmonary stenosis (VPS) as it is highly effective and safe in children and adults. This study evaluated the immediate results of BPV and also heart remodeling in midterm follow up.

Cited by 8 publications

References 22 publications

Results of Transcatheter Therapy with Balloon Versus Stent for Treating Isolated Branch Pulmonary Artery Stenosis in Children and Adolescents: A Midterm Study

Results of Transcatheter Therapy with Balloon Versus Stent for Treating Isolated Branch Pulmonary Artery Stenosis in Children and Adolescents: A Midterm Study

Minimally invasive versus sternotomy approach for double‐patch repair of partial anomalous pulmonary venous connection and sinus venosus defect in pediatric and adult patients: Mid to long‐term outcomes

Resultados de la valvuloplastia percutánea con balón en la estenosis valvular pulmonar en población pediátrica en el Instituto Nacional Cardiovascular – INCOR, Lima – Perú

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