Critical pulmonary stenosis in infants and neonates in the era of interventional cardiology

Bilkis Banu Shri Abd. Aziz, M. Alwi, S. Hasri, A. L. Haifa, K. Geetha, H. I A Law

Research output: Contribution to journalArticle

Abstract

Between September 1992 and February 1998, 22 consecutive patients aged 4 to 90 days with critical valvular pulmonary stenosis underwent percutaneous transluminal balloon valvuloplasty. Sixteen were cyanosed and 7 required prostaglandin infusion. The pulmonary valve was successfully crossed in all patients. Progressive dilatation was used to attain a final balloon to valve ratio between 1.2 and 1.4. Mean right ventricular systolic pressure dropped from 109±26 to 34±1 mm Hg. Oxygen saturation increased from 84%±8% to 98%±2%. There were 5 complications including 1 death due to valvular damage, 1 hemopericardium requiring drainage and transfusion, significant blood loss during cannulation in 2 cases, and a fractured guidewire that was retrieved in another. Repeat valvuloplasty was performed in 2 patients. Two patients required surgery; one had a dysplastic pulmonary valve with persistent pulmonary stenosis and the other had a hypoplastic right ventricle. Of the 20 patients who had valvuloplasty alone, 17 (85%) remained well with a mean peak systolic Doppler gradient of 30±26 mm Hg and no pulmonary regurgitation. We concluded that valvuloplasty is likely to be the only procedure necessary for the majority of infants and neonates with critical pulmonary stenosis. However, surgery is required in cases of dysplastic pulmonary valve or hypoplastic right ventricle.

Original languageEnglish
Pages (from-to)40-45
Number of pages6
JournalAsian Cardiovascular and Thoracic Annals
Volume7
Issue number1
Publication statusPublished - 1999
Externally publishedYes

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Pulmonary Valve Stenosis
Cardiology
Pulmonary Valve
Newborn Infant
Heart Ventricles
Pulmonary Valve Insufficiency
Balloon Valvuloplasty
Pericardial Effusion
Ventricular Pressure
Catheterization
Blood Transfusion
Prostaglandins
Dilatation
Drainage
Oxygen
Blood Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Critical pulmonary stenosis in infants and neonates in the era of interventional cardiology. / Shri Abd. Aziz, Bilkis Banu; Alwi, M.; Hasri, S.; Haifa, A. L.; Geetha, K.; Law, H. I A.

In: Asian Cardiovascular and Thoracic Annals, Vol. 7, No. 1, 1999, p. 40-45.

Research output: Contribution to journalArticle

Shri Abd. Aziz, Bilkis Banu ; Alwi, M. ; Hasri, S. ; Haifa, A. L. ; Geetha, K. ; Law, H. I A. / Critical pulmonary stenosis in infants and neonates in the era of interventional cardiology. In: Asian Cardiovascular and Thoracic Annals. 1999 ; Vol. 7, No. 1. pp. 40-45.
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