[Percutaneous pulmonary valvuloplasty in children and adults: immediate results].
Between April 1987 and December 1993, 60 consecutive patients with valvular pulmonary stenosis underwent percutaneous balloon valvuloplasty in the cardiology department of Monastir. The average age was 13.9 +/- 10.9 years (3 days-44 years). Fifteen patients were over 17 years of age and 4 were less than one year old. The right ventricular systolic pressure fell from 116.5 +/- 39.5 mmHg to 55 +/- 19.7 mmHg (p < 0.0001) immediately after the procedure. The peak-to-peak systolic gradient between the right ventricle and pulmonary artery fell from 95.4 +/- 40.2 mmHg to 30.4 +/- 19.0 mmHg (p < 0.00001), the valvular-gradient fell from 87.5 +/- 39.6 mmHg to 14.7 +/- 11.1 mmHg (p < 0.00001) and the infundibular pressure gradient increased slightly from 8.0 +/- 14.0 mmHg to 15.6 +/- 18.6 mmHg (p = 0.06). The systolic pulmonary artery pressure increased from 21.6 +/- 6.0 mmHg to 25.2 +/- 6.3 mmHg (p = 0.0015). The mean pulmonary artery pressure from 15.6 +/- 4.8 mmHg to 17.3 +/- 4.9 mmHg (p = 0.028). There were no changes in pulmonary diastolic pressures (10.6 +/- 3.7 mmHg vs 9.2 +/- 3.5 mmHg, p = 0.6). There were 4 primary failures (6.4%) with residual valvular gradients > or = 30 mmHg, including one due to valvular dysplasia. No predictive factors of primary failure could be identified. An infundibular gradient > or = 20 mmHg was observed in 11 patients, 4 of whom had gradients > or = 50 mmHg (6.6%); two gradients were residual and 2 were created by pulmonary valvuloplasty.(ABSTRACT TRUNCATED AT 250 WORDS)
Maatouk
F
F
Service de cardiologie, CHU Fattouma Bourguiba, Monastir, Tunisie.
Betbout
F
F
Ben Farhat
M
M
Ayari
M
M
Gamara
H
H
Jarrar
M
M
Hammami
S
S
Boussaïdia
H
H
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D006328:Cardiac Catheterization; D002404:Catheterization / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011664:Pulmonary Valve / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology; D011666:Pulmonary Valve Stenosis / Q000151:congenital / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors
La valvuloplastie pulmonaire percutanée chez l'enfant et l'adulte; résultats immédiats.