EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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 ISSN 2394-3211

Impact Factor: 6.222

 ICV - 79.57

Abstract

EVALUATION OF INITIAL AND MEDIUM-TERM RESULTS OF BALLOON PULMONARY VALVULOPLASTY IN CRITICAL VALVULAR PULMONARY STENOSIS IN NEONATES AND YOUNG INFANTS

Hani Mahmoud Adel*

ABSTRACT

Introduction: Critical pulmonary valve stenosis (PVS) is a life-threatening congenital heart defect. Balloon pulmonary valvuloplasty was first introduced as a therapeutic procedure by Kan et al in 1982. Over the years, management of critical PVS in young infants has evolved from surgical reconstruction of the right ventricular outflow tract and closed pulmonary valvotomy to transcatheter balloon pulmonary valvuloplasty (BPV), which is now the standard therapeutic procedure. Objectives: To evaluate the initial and medium-term results of BPV in neonates and young infants with critical PVS as carried out at the Alexandria University Children’s Hospital. Patients and Methods: From 2009 through 2017, 61 neonates and young infants with critical PVS were subjected to BPV. They were followed-up by clinical and echocardiographic evaluation for 1->7 years, after BVP. Results: The mean age of the patients was 48.9 ± 45.3 days and mean weight was 4.29 ± 1.33 kg. The mean PV annulus diameter by echo was 8.3± 1.2(6-11.5) mm, whereas by angiographic measurement was 7.9± 1.2 mm (5.4-11.5). The mean Doppler gradient across the PV was 128.1±15.8 mmHg and the mean catheter gradient was 96.7±11 mmHg. The mean inflated balloon diameter was 10.4±1.5 mm. The balloon/PV annulus ratio by angiogram was 1.32±0.06. The mean pressure gradient across PV post-ballooning was 21.7±9.7 mmHg by Doppler and 1.9 ± 6.4 mmHg by catheter. The SaO2 increased from 88.9±3.1% pre-ballooning to 94.3±1.9% post-ballooning. Complete success was achieved in 58 cases (95%). Complications were encountered in 5 cases (8.2%), all recovered completely. Residual gradient occurred in 3 cases (4.9%). Re-intervention was done in 5 cases (8.2%). Conclusions: BPV for critical PVS in neonates and young infants is feasible, effective and safe; and offers a great chance of saving such babies, but is technically demanding and could have some complications.

Keywords: Critical pulmonary stenosis-Balloon pulmonary valvuloplasty- Newborn-Infants.


[Full Text Article]

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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI )