title: Pulmonary balloon valvuloplasty in the palliation of complex cyanotic congenital heart disease.
abstract: OBJECTIVE
  To assess the value of pulmonary balloon valvuloplasty in the interim palliation of complex congenital heart disease and pulmonary stenosis in children, who often require numerous palliative operations before definitive surgical repair.
  
  
  METHODS
  Evaluation of pulmonary balloon valvuloplasty procedures performed over a five year period in 18 patients (age 8 days--29 years; mean 5.5 years) with complex cyanotic congenital heart disease.
  
  
  RESULTS
  After pulmonary balloon valvuloplasty oxygen saturation increased from a mean (SD) of 69 (7.5)% to 83 (7.0)% (P < 0.001). Mean pulmonary artery pressure increased from a mean (SD) of 11.3 (3.8) mm Hg to 15.7 (3.9) mm Hg (P < 0.001). Transient complete atrioventricular block occurred in one patient. No other complications were encountered. In 5 patients (28%) there was an inadequate improvement in cyanosis compared with pre-procedure values (72 (4.7)% v 66 (8.1)%). Reasons for failure were increasing infundibular stenosis in three and inadequate mixing in one child. In 13 patients (72%) pulmonary balloon valvuloplasty gave adequate interim palliation over a mean follow up of 1.1 (1.3) years. Oxygen saturation was 81 (5.6)% at last follow up compared with 70 (7.3)% before pulmonary balloon valvuloplasty (P < 0.001).
  
  
  CONCLUSIONS
  Pulmonary balloon valvuloplasty is a safe and effective technique in the palliation of patients with complex cyanotic congenital heart disease associated with pulmonary valve stenosis.
authors.affiliation: Service de Cardiologie Pédiatrique, Hôpital Necker/Enfants-Malades, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Stümper
authors.forename: J F
authors.initials: JF
authors.lastname: Piéchaud
authors.forename: P
authors.initials: P
authors.lastname: Bonhoeffer
authors.forename: D
authors.initials: D
authors.lastname: Bonnet
authors.forename: Y
authors.initials: Y
authors.lastname: Aggoun
authors.forename: D
authors.initials: D
authors.lastname: Sidi
authors.forename: J
authors.initials: J
authors.lastname: Kachaner
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003490:Cyanosis / Q000628:therapy; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000097:blood / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood; D010166:Palliative Care / Q000379:methods*; D011666:Pulmonary Valve Stenosis / Q000628:therapy*
chemical_list: D010100:Oxygen