Outcomes for balloon pulmonary valvuloplasty in adults: Comparison with a concurrent pediatric cohort

Taggart, Nathaniel W.; Cetta, Frank; Cabalka, Allison K.; Hagler, Donald J.

doi:10.1002/ccd.24973

Cited by 18 publications

(4 citation statements)

References 20 publications

(20 reference statements)

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“…The peak to peak pressure gradient across pulmonary valve reduced from pre procedure value of 121.9±53.2 mmHg to post procedure value of 30.1±11.9 mmHg which is quite a significant reduction and this successfulness of the procedure is comparable to different studies from recent and past around the world. 8,9 Taguart N et al 10 in their comparative study described a significant drop in pressure gradient across pulmonary valve in adults as compared to children. In a study conducted in Lahore by Sehar T et al on BPV, it was seen if the pre valvuloplasty gradient is less and the valve is doming the success rate of BPV is 96.7% as compared to dysplastic valve or high gradient before the procedure.…”

Section: Discussionmentioning

confidence: 97%

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

2020

APMC

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Background: Balloon pulmonary valvuloplasty is the procedure of choice for pulmonary valve stenosis in any age group. The data on efficacy of the procedure in adolescent and adult population is scanty in Pakistan. Objective: To determine the early outcome of balloon pulmonary valvuloplasty in adolescents and adults. Study Design: Descriptive retrospective case series. Settings: Pediatric cardiology department of Faisalabad Institute of Cardiology, Faisalabad-Pakistan. Duration: Three years and Six months from 01-01-2016 to 30-06-2019. Methodology: All consecutive patients of age 10 years or above who underwent percutaneous balloon pulmonary valvuloplasty in the study period were enrolled. The outcome parameters including successfulness and complications of procedure recorded. The procedure was labelled successful if peak to peak pressure gradient across pulmonary valve reduced to less than 50% or more of the pre procedure value, suboptimal if gradient reduced by 25-49% and unsuccessful if gradient reduced by less than 25%. Results: A total of 41 patients underwent balloon pulmonary valvuloplasty procedure. Mean age was 22.2± 10.5 years while female to male ratio was 1.05:1. Majority of the patients (n=26, 63.4%) were symptomatic and dyspnea on exertion was the dominant symptom (n=16, 39%). Majority of the patients had doming pulmonary valve (n=37, 90.2%). Mean balloon to pulmonary valve annulus ratio was 1.24 ± 0.1 (range 1.1-1.43). The procedure was successful in all patients (n=41, 100%) as the mean peak to peak pressure gradient across pulmonary valve decreased from 121.9 ± 53.2 mmHg (pre valvuloplasty) to 30.1±11.9 mmHg (post valvuloplasty) irrespective of doming or dysplastic valve. There were no major complications. Transient self-limiting vaso-vagal syncope was noted in 7.3% of patients (n=3). On post procedure echocardiography there was not a single case of moderate or severe pulmonary valve regurgitation (PR) while mild PR was observed in 48.8% patients (n=20). Conclusion: Balloon pulmonary valvuloplasty in adolescent and adult patients is a very safe procedure with high success but very low complications rate.

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Section: Discussionmentioning

confidence: 97%

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

2020

APMC

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“…In most cases, balloon pulmonary valvuloplasty is the preferred intervention. The procedure is minimally invasive and experienced centers have published generations of reassuring safety and efficacy data (72)(73)(74)(75)(76)(77). A major limitation of balloon valvuloplasty, however, is its high rate of subsequent pulmonic regurgitation (PR).…”

Section: A B C F E Dmentioning

confidence: 99%

“…A major limitation of balloon valvuloplasty, however, is its high rate of subsequent pulmonic regurgitation (PR). This can be progressive and lead to RV dysfunction (75,(78)(79)(80). The presence of symptoms attributable to post-procedural PR is a Class I indication for valve replacement (59).…”

Section: A B C F E Dmentioning

confidence: 99%

Valvular heart disease in congenital heart disease: a narrative review

Saef¹,

Ghobrial²

2021

Cardiovasc Diagn Ther

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Congenital heart defects are the most common type of birth defects, and with recent advances leading to improved survival, there are now over two million infants, children, and adults with congenital heart disease (CHD) in the United States alone (1-3). Many patients suffer from primary congenital valvular lesions or prosthetic/conduit valvular dysfunction. Given the substantial variability within each phenotype of CHD, this review will provide a basic background in embryology to allow the reader to create an adaptable construct in their approach to these patients (Table 1).As the prevalence of CHD grows, it is imperative that providers in all practice settings recognize pathology promptly, coordinate appropriate surveillance, and collaborate with CHD-specialists for optimal treatment. As such, this review provides details on the diagnosis, natural history, and contemporary therapeutic approaches to valvular heart disease in CHD. The information used to write this review was collected via computerized literature searches of electronic databases including U.S. National Library of Medicine (MEDLINE), ScienceDirect, and Google Scholar as well as hand searches of the references of the retrieved literature and discussions with experts in

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“…Additionally, in some cases, this defect is combined with genetic syndromes (8)(9). despite the introduction of novel approaches to PS correction, such as balloon pulmonary valvuloplasty (10)(11). Since surgical valvoplasty is an alternative procedure, it is considered for pediatrics with the main pathologic patterns, such as hypoplastic pulmonary annuli or severe pulmonary regurgitation (12).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of pulmonary valve replacement surgery in pediatrics: a single-center experience long-term study

2022

jsurgery

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Introduction: Heart valve disease in pediatricsis an increasing global concern, especially in developing countries. This study aims to determine the clinical outcomes of pulmonary valve replacement (PVR) surgery in pediatrics. Methods: The authors retrospectively identified all pediatrics undergoing PVR surgery at Imam Reza hospital (Mashhad, Iran) between 2000 and 2020. Their medical records were reviewed for demographic characteristics, clinical data (intra-operative and postoperative), and follow-up results. Echocardiography and electrocardiography were performedonall patients before the surgery and periodically after the surgery. Results: Among 50 pediatrics undergoing surgical PVR, 38 (76%) were female and others were male (14%), with a mean age of 10.39±5.31 years. The leading cause of PVR was the Tetralogy of Fallot. There was a significant relationship between age at the time of surgery and the size of the pulmonary valve(P=0.02).There were also statistically significant differences between QTc intervals before and after surgery (P=0.001). Further more, there was a significant correlation between QTc intervals before and after surgery and the ageof pediatrics at the time of surgery (P=0.01, r=-0.6).There was also a statistically significant relationship between the ICU stay (P=0.01) and the weaning time of the mechanical ventilation (P=0.03). Conclusion: It is recommended that this procedure ispostponed as much as possible to decrease postoperative life-threatening events in pediatrics.In addition, if this surgery is conducted with good surgical and nursing management, it can be safe with low complications among other cardiac valve procedures.

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Outcomes for balloon pulmonary valvuloplasty in adults: Comparison with a concurrent pediatric cohort

Abstract: BPV is an effective procedure for symptomatic adults with pulmonary valve stenosis. In addition to immediate relief of RVOT gradient, adult patients may experience symptomatic improvement following BPV.

Cited by 18 publications

References 20 publications

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

Early Outcome of Balloon Pulmonary Valvuloplasty for Pulmonary Valve Stenosis in Adolescents and Adults: Experience at A Tertiary Care Cardiac Institute

Valvular heart disease in congenital heart disease: a narrative review

Clinical outcomes of pulmonary valve replacement surgery in pediatrics: a single-center experience long-term study

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