Radiofrequency-assisted balloon dilatation in patients with pulmonary valve atresia and an intact ventricular septum.
OBJECTIVE
To investigate the efficacy and safety of transcatheter radiofrequency-assisted valve dilatation for infants with pulmonary valve atresia and intact ventricular septum as an alternative to the use of laser heated wires.


METHODS
Prospective clinical study.


METHODS
Three paediatric cardiology centres.


METHODS
Four children (aged 5-101 days, weight 2.8 kg) with pulmonary valve atresia and intact ventricular septum underwent percutaneous radiofrequency-assisted valve dilatation.


METHODS
After delineating the atretic valve by angiography, 0.020 inch or 0.018 inch radiofrequency wires were used to perforate the atretic valve. The valve was then dilated with conventional balloon dilatation catheters up to the valve annulus diameter.


RESULTS
In all four cases the radiofrequency wire perforated the atretic pulmonary valve and balloon dilatation was successful. In one patient the radiofrequency wire also passed through the anterior wall of the pulmonary artery causing tamponade which required surgical repair shortly afterwards. This patient died from sepsis six days later. One patient died three weeks after the procedure from septicaemia and a paradoxical coronary embolus. Two patients were discharged after 4 and 14 days respectively.


CONCLUSIONS
Radiofrequency-assisted valve dilatation is a promising alternative to the recently developed laser wire technique. The major advantages are a reduction in cost and improved safety for the staff performing the procedure.
Rosenthal
E
E
Department of Paediatric Cardiology, Guy's Hospital, London.
Qureshi
S A
SA
Chan
K C
KC
Martin
R P
RP
Skehan
D J
DJ
Jordan
S C
SC
Tynan
M
M
D021721:Balloon Occlusion; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D002404:Catheterization / Q000379:methods*; D000013:Congenital Abnormalities / Q000628:therapy; D005260:Female; D006346:Heart Septum / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011664:Pulmonary Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography