title: Double balloon pulmonary valvuloplasty: multi-track system versus conventional technique.
abstract: OBJECTIVE
  To evaluate whether double balloon pulmonary valvuloplasty (DBPV) with the Multi-Track system (MTS) may help to simplify the procedure.
  
  
  BACKGROUND
  DBPV is usually required for patients with pulmonary valve stenosis with large annulus. However, it needs two venous accesses and can be technically demanding.
  
  
  METHODS
  From 07/03, 20 consecutive patients (19 +/- 10 yrs) with typical pulmonary valve stenosis underwent DBPV using the MTS (G1). The results were compared with those achieved by conventional DBPV performed in a matched historical group of 28 patients (21 +/- 11 yrs; P = NS) (G2).
  
  
  RESULTS
  MTS balloons were easily advanced through the skin and inflated across the valve. Similar results were observed in regards to residual gradients (12 +/- 11 vs 14 +/- 10 mm Hg; P = NS) and right ventricular to systemic pressures (0.35 +/- 0.22 vs 0.37 +/- 0.26; P = NS). Procedure and fluoroscopic times were significant lower in G1 (78 +/- 24 vs 126 +/- 28; 15 +/- 12 vs 25 +/- 8 min, respectively; both P < 0.001). There was no major complication. Median follow-up was 1.8 yr for G1 and 5 yr for G2 (P = 0.037). At the last visit, peak instantaneous gradient across the right ventricular outflow tract by echocardiography was a mean 22 +/- 10 mm Hg for G1 and 25 +/- 9 mm Hg for G2 (P = NS). No patient had severe pulmonary insufficiency or required reintervention.
  
  
  CONCLUSIONS
  The use of the MTS helped to expedite the procedure providing satisfactory midterm clinical outcomes, similar to those observed with the conventional DBPV technique.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil. cacpedra@uol.com.br carlosacpedra@hotmail.com
authors.forename: Carlos A C
authors.initials: CA
authors.lastname: Pedra
authors.forename: S Raul
authors.initials: SR
authors.lastname: Arrieta
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Esteves
authors.forename: Sérgio L N
authors.initials: SL
authors.lastname: Braga
authors.forename: Juliana
authors.initials: J
authors.lastname: Neves
authors.forename: Renata
authors.initials: R
authors.lastname: Cassar
authors.forename: Simone R F
authors.initials: SR
authors.lastname: Pedra
authors.forename: M Virginia T
authors.initials: MV
authors.lastname: Santana
authors.forename: M Aparecida P
authors.initials: MA
authors.lastname: Silva
authors.forename: J Eduardo M R
authors.initials: JE
authors.lastname: Sousa
authors.forename: Valmir F
authors.initials: VF
authors.lastname: Fontes
mesh_terms: D000293:Adolescent; D000328:Adult; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D011666:Pulmonary Valve Stenosis / Q000628:therapy*; D016896:Treatment Outcome