Reinterventions in patients with pulmonary atresia and intact ventricular septum after transcatheter pulmonary valve perforation

Authors

  • A. V. Maksymenko ДУ «Науково-практичний медичний центр дитячої кардіології та кардіохірургії» МОЗ України, Київ
  • D. O. Shypov ДУ «Науково-практичний медичний центр дитячої кардіології та кардіохірургії» МОЗ України, Київ
  • O. O. Motrechko ДУ «Науково-практичний медичний центр дитячої кардіології та кардіохірургії» МОЗ України, Київ
  • Yu. L. Kuzmenko ДУ «Науково-практичний медичний центр дитячої кардіології та кардіохірургії» МОЗ України, Київ
  • A. A. Dovhaliuk ДУ «Науково-практичний медичний центр дитячої кардіології та кардіохірургії» МОЗ України, Київ

DOI:

https://doi.org/10.11603/2414-4533.2018.2.9185

Keywords:

pulmonary atresia with intact interventricular septum, perforation of the pulmonary valve, repeated interventions.

Abstract

The aim of the work: to determine the factors that influence the frequency of reinterventions in the postoperative period after perforation of the pulmonary artery valve in patients with pulmonary atresia and intact ventricular septum (PA/IVS).

Materials and Methods. Perioperative data (ECHO and Cath Lab data) were reviewed retrospectively for all patients with PA/IVS, who underwent pulmonary valve perforation in our institution from September 2003 to December 2014.

Results and Discussion. Perforation and further balloon valvuloplasty of the pulmonary artery valve in newborn patients with PA/ IVS is an effective and safe procedure for restoring antegrade pulmonary blood flow. In our group of patients, the efficacy was 87 % (n = 41). Hospital mortality was 4.8 % (n = 2). However, despite the advantages of this technique, a significant number of patients require repeated interventions. The frequency of reinterventions in the early postoperative period was 34 % (n = 14) and was associated with the need to create an additional source of pulmonary blood flow. Among the factors that influenced the frequency of reinterventions in the early postoperative period were the following indicators: the size of the tricuspid valve ring and its corresponding Z-score; the ratio of the tricuspid valve size to the mitral valve size; siz e of interatrial communication.

In the long-term period, 11 patients (27 %) needed repeated operations. All reinterventions were directed to the right ventricular out­flow tract (RVOT) plasty. The only indicator that is able to predict the need for repeated intervention was the pressure gradient on the outflow tract.

Author Biography

A. V. Maksymenko, ДУ «Науково-практичний медичний центр дитячої кардіології та кардіохірургії» МОЗ України, Київ

 

References

Hasan, B.S., Bautista‐Hernandez, V., & McElhinney, D.B. (2013). Outcomes of transcatheter approach for initial treatment of pulmonary atresia with intact ventricular septum. Catheter. Cardiovasc. Interv., 81, 111-118.

Freedom, R.M., Mawson, J.B., Yoo, S.-J., & Benson, L.N. (Eds.). (1997). Pulmonary atresia and intact ventricular septum. Congenital Heart Disease. Textbook of Angiocardiography, 1. Mount Kisco, NY: Futura.

Qureshi, S.A., Rosenthal, E., & Michael, T. (1991). Transcatheter laser-assisted balloon pulmonary valve dilation in pulmonary valve atresia. Am. J. Cardiol., 67, 428-431.

Agnoletti, G., Piechaud, J.F., & Bonhoeffer, P. (2003). Perforation of the atretic pulmonary valve. Long-term follow-up. J. Am. Coll. Cardiol., 41, 1399-1403.

Marasini, M., Gorrieri, P.F., & Tuo, G. (2009). Long-term results of catheter-based treatment of pulmonary atresia and intact ventricular septum. Heart, 95, 1520-1524.

Rathgeber, S., Auld, B., & Duncombe, S. (2017). Outcomes of radiofrequency perforation for pulmonary atresia and intact ventricular septum: A single-centre experience. Pediatr. Cardiol., 38, 170-175.

Humpl, T., Söderberg, B., McCrindle, B.W., Nykanen, D.G., Freedom, R.M., & Williams, W.G. (2003). Percutaneous balloon valvotomy in pulmonary atresia with intact ventricular septum: impact on patient care. Circulation, 108, 826-832.

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Published

2018-07-20

How to Cite

Maksymenko, A. V., Shypov, D. O., Motrechko, O. O., Kuzmenko, Y. L., & Dovhaliuk, A. A. (2018). Reinterventions in patients with pulmonary atresia and intact ventricular septum after transcatheter pulmonary valve perforation. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 24–30. https://doi.org/10.11603/2414-4533.2018.2.9185

Issue

No. 2 (2018)

Section

ORIGINAL INVESTIGATIONS

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