Partial and transient relief of conduit obstruction by low-pressure balloon dilation in patients with congenital heart disease.
Seven patients underwent attempted low pressure balloon dilation of stenotic conduits or homografts from right ventricle to pulmonary artery (n = 5), in the aortic valve position (n = 1), or from right atrium to left pulmonary artery (n = 1). In the right ventricle to pulmonary artery group, mean gradient reduction was only 17%. At follow-up, two patients underwent surgical conduit replacement, one had a stent implanted at cardiac catheterization, the other two are awaiting surgical intervention. The patient with a homograft in the aortic valve position had a good initial result but restenosed within 1 year and underwent a pulmonary autograft operation. The patient with the Fontan homograft stenosis had transient obstruction relief but subsequently required stent implantation. Low-pressure balloon dilation of conduits or homografts is only partially and transiently successful. Whether stent implantation will offer better long-term results remains to be determined.
Sohn
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S
Department of Pediatrics, University of California San Diego, USA.
Kashani
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IA
Rothman
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D000293:Adolescent; D001021:Aortic Valve; D001705:Bioprosthesis; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006330:Heart Defects, Congenital / Q000473:pathology / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011651:Pulmonary Artery / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome