Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults.
Cardiol Young
; 22(5): 589-95, 2012 Oct.
Article
in En
| MEDLINE
| ID: mdl-22398105
ABSTRACT
OBJECTIVES:
To evaluate the results of balloon dilatation of stenotic homografts in children, adolescents, and young adults and to identify factors that might influence or predict the effect of the dilatation.BACKGROUND:
Homografts are widely used in congenital cardiac surgery; however, the longevity remains a problem mostly because of stenosis in the homograft. The effect of treatment by balloon dilatation is unclear.METHODS:
In a retrospective study, the effect of balloon dilatation was determined by the percentage of reduction of the peak systolic pressure gradient over the homograft during catheterisation and the postponement of re-intervention or replacement of the homograft in months. Successful dilatations - defined in this study as a reduction of more than 33% and postponement of more than 18 months - were compared with unsuccessful dilatations in search of factors influencing or predicting the results.RESULTS:
The mean reduction of the peak systolic pressure gradient was 30% in 40 procedures. Re-intervention or replacement of the homograft was postponed by a mean of 19 months. In all, 14 balloon dilatations (35%) were successful; the mean reduction was 49% and the mean postponement was 34 months. The time since homograft implantation, the presence of calcification, the homograft/balloon ratio, and the pressure applied during dilatation all tended to correlate with outcome, but were not statistically significant.CONCLUSIONS:
Balloon dilatation is able to reduce the peak systolic pressure gradient over homografts in a subgroup of patients and can be of clinical significance to postpone re-intervention or pulmonary valve replacement.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Valve Insufficiency
/
Aortic Valve Stenosis
/
Pulmonary Valve
/
Heart Valve Prosthesis
/
Balloon Valvuloplasty
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Cardiol Young
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
PEDIATRIA
Year:
2012
Document type:
Article
Affiliation country:
Netherlands