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Experience with balloon pulmonary valvuloplasty and predictors of outcome: a ten-year study

Published online by Cambridge University Press:  19 February 2020

Sonia A. El-Saeidi ,
Hala S. Hamza ,
Hala M. Agha ,
Mohammed M. Soliman ,
Wael A. Attia Open the ORCID record for Wael A. Attia [Opens in a new window] ,
Rania El-Kaffas ,
Faten Abdel-Aziz ,
Osama Abdel-Aziz ,
Sahar Shaker  and
Amira Esmat
...Show all authors
Sonia A. El-Saeidi
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Hala S. Hamza
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Hala M. Agha
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Mohammed M. Soliman
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Wael A. Attia*
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Rania El-Kaffas
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Faten Abdel-Aziz
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Osama Abdel-Aziz
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Sahar Shaker
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Amira Esmat
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Rasha Ammar
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Aya Fattouh
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Khalid Mohi-eldin
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
Amal M. El-Sisi
Affiliation:
Paediatric Department, Cardiology Division, Cairo University, Cairo, Egypt
*
Author for correspondence: W. Attia, Paediatric Department, Cardiology Division, Cairo University, 1 Ali Ibrahim Street, Alsayeda Zainab, Cairo, Egypt. Tel: +20201111927252. E-mail: [email protected]
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Abstract

Background:

Balloon pulmonary valvuloplasty is the treatment of choice for patients with moderate to severe pulmonary valve stenosis.

Methods:

An observational retrospective cross-sectional study including neonates, small infants, and children who underwent balloon pulmonary valvuloplasty in the period from 2007 to 2016 in the cardiac catheterisation unit of the paediatric cardiology department in Cairo University. Multivariable models were built to report the predictors of the outcome of balloon pulmonary valvuloplasty and its complications.

Results:

A total of 1200 patients were included in the study and divided according to age into 3 groups: neonates and early infants (n = 282), infants (n = 362), and children (n = 556). Procedural success, defined as a drop pressure gradient across the pulmonary valve to less than or equal to 50% of the baseline measurements, was achieved in 82.7% of the patients. Multivariate analysis revealed that only infundibular pulmonary stenosis (p value 0.032), supravalvular in association with valvular pulmonary stenosis (p value <0.001), and pulmonary valve diameter by angiogram (p value <0.001) were significant predictors of success. The presence of supravalvular in association with valvular pulmonary stenosis (p value <0.001) was associated with a lower weight (p value 0.007) and higher right ventricular pressure before the intervention (p value <0.001), and a minor immediate drop in the pressure gradient post-intervention (p value <0.001) was found to be the most significant predictor of the occurrence of complications.

Conclusion:

The absence of infundibular and supravalvular stenosis and a large pulmonary valve diameter were the most significant predictors of success.

Keywords

Valvular pulmonary stenosispercutaneousballoon valvuloplasty
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 4 , April 2020 , pp. 482 - 488
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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