Closed pulmonary valvotomy in infants under 6 months of age: report of 14 consecutive cases without mortality.

Abstract

Eight patients underwent cardiac catheterisation and were operated on as emergency cases. Three of these were in a preterminal condition, four were in respiratory distress, and one was tachypnoeic, but with no distress. In the remaining six patients the indication for surgery was as follows: severe cyanosis in four infants (cases 4, 5, 10, 12)

Surgical closed pulmonary valvotomy for critical pulmonary stenosis: implications for the balloon valvuloplasty era.

“…By five years after the initial operation 22 (67%) had not required further surgery compared with 19 (58%) at eight years. No patient 10 2 Technical mistake; intraoperative death 11 2 Technically inadequate valvotomy apparent at necropsy, the perforation being on the floor of one sinus, and a shunt done later thrombosed; death two weeks later from general sepsis 12 3 Emergency operation performed directly from the catheterisation table; unnoticed residual heparin activity led to bleeding and tamponade several hours after seemingly good valvotomy 14 4 Dysplastic pulmonary valve found at necropsy; death from low cardiac output within 24 hours 16 6 Traumatic operation (8 mm dilatation); death within several hours Surgical closed pulmonary valvotomyfor critical pulmonary stenosis tThe Doppler method was introduced later in the series and some patients therefore did not have it.…”