Balloon pulmonary valvuloplasty in tetralogy of Fallot: effects on growth of pulmonary annulus and transannular patch.
BACKGROUND
Balloon pulmonary valvuloplasty and its benefit on the growth of pulmonary annulus and pulmonary artery in tetralogy of Fallot (TOF) patients remains controversial. The purpose ofthe present study was to determine the growth of pulmonary valve annulus and pulmonary artery and to evaluate the need of transannular patch during total surgical correction in patients with tetralogy of Fallot (TOF) after balloon pulmonary valvuloplasty.


METHODS
Fifty-one severely hypoxic TOF patients, who underwent balloon dilatation ofpulmonary valve, were included in the present study. The clinical outcomes, oxygen saturation, and echocardiographic parameters before and after balloon dilatation were analyzed.


RESULTS
There were 33 males and 18females. The mean age was 3 years 5 months old (range, I month-15 years 8 months old). The mean oxygen saturation increasedfrom 73.9 +/- 9.1 to 84.8 +/- 6.7% immediately after the procedure (p-value < 0.05). There was no serious procedural-related complication. At the mean follow-up period of 2 years and 4 months, the mean Z-score of pulmonary annulus size increased from -2.56 SD to -1.87 SD (p-value < 0.05) and the right pulmonary artery size from -0.29 SD to + 0.46 SD (p-value < 0.05). Thirty-seven patients (66.1%) underwent corrective surgery. Pulmonary transannular patch was performed in 11 of37 patients (29.7%).


CONCLUSIONS
Pulmonary valve dilatation in patients with TOF is safe. It promotes the growth ofthe pulmonary valve annulus and pulmonary artery and may decrease the need of transannular patch at the time of surgical correction.
Cholkraisuwat
Engcanit
E
Department of Pediatrics, Faculty of Medicine, Naresuan University Pitsanulok, Thailand.
Lertsapcharoen
Pornthep
P
Khongphatthanayothin
Apichai
A
La-orkhun
Vidhavas
V
Vithessonthi
Kanyalak
K
Benjacholamas
Vichai
V
Namchaisiri
Jule
J
D000293:Adolescent; D006328:Cardiac Catheterization; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care / Q000379:methods; D011651:Pulmonary Artery / Q000254:growth & development; D011664:Pulmonary Valve / Q000254:growth & development; D011666:Pulmonary Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D012307:Risk Factors; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome