Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T00:48:27.855Z Has data issue: false hasContentIssue false

Balloon dilation of the right ventricular outflow tract in tetralogy of Fallot: a palliative procedure

Published online by Cambridge University Press:  19 August 2008

Sameh M. Arab*
Affiliation:
Cardiology Department, Alexandria University, Main University Hospital
Abdel-Fattah E. Kholeif
Affiliation:
Cardiology Department, Alexandria University, Main University Hospital
Salah R. Zaher
Affiliation:
Paediatrics Department, Alexandria University, Shatby Hospital, Alexandria, Egypt
Aly M. Abdel-Mohsen
Affiliation:
Paediatrics Department, Alexandria University, Shatby Hospital, Alexandria, Egypt
A. Samir Kassem
Affiliation:
Paediatrics Department, Alexandria University, Shatby Hospital, Alexandria, Egypt
Shakeel A. Qureshi
Affiliation:
Paediatric Cardiology Department, Guy's Hospital, London, UK
*
Dr. Sameh M. Arab, Assistant Professor of Cardiology, 40 Safia Zaghloul Street, Alexandria - 21131 -Egypt. Tel.: (203) 481 0788; Fax: (203) 543 1698

Abstract

Fifteen patients requiring palliation for tetralogy of Fallot were treated by balloon dilation because of hypercyanotic spells. The mean age at dilation was 1.9 ± 0.7 years (range 0.5 – 3), and the mean weight 9.8 ± 2.1kg (range 6.0 –13.5). Dilation of the outflow tract was combined with dilation of the left and/or right pulmonary arteries in 5 patients. Successful dilation was achieved in 12 patients (80%), but failed in 3 patients with hypoplastic pulmonary arteries. In one patient, the stenosis of the right pulmonary artery could not be dilated because of a very sharp angle at the site of the stenosis. Two of the 3 patients in whom the procedure failed died of severe cyanotic spells within 24 hours of the unsuccessful procedure. No major complications occurred during or after the procedure in the cases undergoing successful dilation. The arterial oxygen saturation increased significantly, from 71 ± 5.7% to 89 ± 3.9%, immediately after the procedure (p < 0.005). During a period of follow up of 6 ± 3.7 months (range 1 – 13), the procedure was repeated on 3 occasions, and successfully accomplished in 2 of these. In conclusion, balloon dilation is a satisfactory palliative procedure for tetralogy of Fallot in those units in which total correction is not performed under 2 to 3 years of age.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Qureshi, SA, Kirk, CR, Lamb, RK, Arnold, R, and Wilkinson, JL. Balloon dilatation of the pulmonary valve in patients with tetralogy of Fallot: a preliminary study. Br Heart J 1988; 60: 232235.CrossRefGoogle ScholarPubMed
2.Rao, PS and Brais, M. Balloon pulmonary valvuloplasty for congenital cyanotic heart defects. Am Heart J 1988; 115(5): 11051110.Google ScholarPubMed
3.Sluysmans, T, Neven, B, Rubay, J, Lintermans, J, Ovaert, C, Mucumbitsi, J, Shango, P, Stijns, M and Vliers, A. Early balloon dilatation of the pulmonary valve in infants with tetralogy of Fallot. Risks and benefits. Circulation 1995; 91(5): 15061511.CrossRefGoogle ScholarPubMed
4.Tynan, M, S, Arab, Qureshi, S, Baker, E, Anjos, R dos, Parsons, J and Hayes, A. Balloon Pulmonary Valvuloplasty. Chapter 22. In: Hombach, V, Koch, M and Camm, AJ. Interventional techniques in cardiovascular medicine. The Netherlands. Kluwer Academic Publishers. 1991. pages: 187193.CrossRefGoogle Scholar
5.Sharland, GK, Qureshi, SA, Ladusans, EJ, Parsons, JP, Baker, EJ, Deverall, PB and Tynan, MJ. Efficacy and safety of balloon dilatation as a palliative treatment for treatment for tetralogy of Fallot. Cardiol Young 1994; 4: 255261.CrossRefGoogle Scholar
6.Sreeram, N, Saleem, M, Jackson, M, Peart, I, McKay, R, Arnold, R and Walsh, K. Results of balloon pulmonary valvuloplasty as a palliative procedure in Tetralogy of Fallot. J Am Coll Cardiol 1991; 18(1): 159165.CrossRefGoogle ScholarPubMed
7.Black., E Rosenthal, S, Qureshi and P, Deverall. Mechanism of relief of right ventricular outflow obstruction by percutaneous balloon dilatation in Tetralogy of Fallot. Br Heart J 1989; 61: 91.Google Scholar
8.Sommer, R, Golinko, R. Is there a choice of palliation for Tetralogy of Fallot. J Am Coll Cardiol 1991; 18(1): 166167.CrossRefGoogle Scholar
9.Piechaud, JF, Delogu, AB, Iserin, L, Aggoun, Y, Cohen, L, Sidi, D and Kachaner, J. Palliative treatment of tetralogy of Fallot by percutaneous dilatation of the right ventricular outflow tract. 40 cases. Arch Mal Coeur 1994; 87: 573579.Google ScholarPubMed