Controlled transient respiratory arrest along with rapid right ventricular pacing for improving balloon stability during balloon valvuloplasty in pediatric patients with congenital aortic stenosis--a retrospective case series analysis.
Rapid right ventricular pacing is safe, effective, and established method to provide balloon stability during balloon aortic valvuloplasty (BAV). Controlled transient respiratory arrest at this point of time may further reduce left ventricular stroke volume, providing an additional benefit to maintain balloon stability. Two groups were studied. Among the 10 patients, five had rapid pacing alone (Group A), while the other five were provided with cessation of positive pressure breathing as well (Group B). The outcomes of BAV in the two groups of patients were studied. One patient in Group A had failed balloon dilatation even after the fourth attempt, while in Group B there were no failures. The peak systolic gradient reduction was higher in Group B (70.05% in comparison to 52.16% of group A). In Group A, five subjects developed aortic regurgitation (grade 2 in four and grade 3 in one, while no grade 3 aortic regurgitation developed in any patient in Group B). Controlled transient respiratory arrest along with rapid ventricular pacing may be effective in maintaining balloon stability and improve the outcome of BAV.
Gupta
Sampa Dutta
SD
Department of Anaesthesiology, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India. sdg_1603@yahoo.co.in
Das
Soumi
S
Ghose
Tapas
T
Sarkar
Achyut
A
Goswami
Anupam
A
Kundu
Sudeshna
S
D001024:Aortic Valve Stenosis / Q000601:surgery*; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002304:Cardiac Pacing, Artificial; D002404:Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D010100:Oxygen / Q000097:blood; D015656:Respiratory Mechanics / Q000502:physiology*; D012189:Retrospective Studies; D016277:Ventricular Function, Left / Q000502:physiology
D010100:Oxygen