title: Predictors of reintervention in neonates with critical pulmonary stenosis or pulmonary atresia with intact ventricular septum.
abstract: OBJECTIVE
  Describe the short and midterm outcome and to determine the predictors of reintervention in neonates with critical pulmonary stenosis (PS) or pulmonary atresia with intact ventricular septum (PA/IVS).
  
  
  BACKGROUND
  The transcatheter intervention for critical PS and PA/IVS resulted in improvement in the patient's survival and the quality of life. The procedure is not free of complications and there is still a significant rate of reintervention.
  
  
  METHODS
  All neonates with critical PS or PA/IVS who underwent interventional cardiac catheterization between November 2004 and January 2009 were reviewed retrospectively. We performed a comparison between those who required reintervention and those who did not, to identify the predictors of reintervention.
  
  
  RESULTS
  Forty-three neonates were included, 23 (53.5%) had critical PS and 20 (46.5%) had PA/IVS. Twenty-six patients (60%) were males, the mean age was 11 ± 8 days, and the mean weight was 3.2 ± 0.6 kg. Two patients died (4.6%). The mean follow-up period was 19 ± 13 months for 42 patients. Fifteen patients (36%) required reintervention, 11 of them (73%) had PA/IVS, and 4 (27%) had critical PS. Reintervention was more in patients with PA/IVS than those with critical PS (P = 0.003). Other predictors for reintervention included hospital stay ≥ 7.5 days (P = 0.001) and tricuspid valve regurgitation peak gradient in day one post first intervention (TR1) ≥ 43 mm Hg (P = 0.03).
  
  
  CONCLUSIONS
  Interventional cardiac catheterization shows favorable outcome for patients with critical PS and PA/IVS. Predictors for reintervention included the diagnosis of PA/IVS, hospital stay ≥7.5 days after first intervention and TR1 gradient ≥ 43 mm Hg.
authors.affiliation: Department of Cardiac Sciences, King Abdulaziz Medical City, National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Ghassan
authors.initials: G
authors.lastname: Shaath
authors.forename: Mansour
authors.initials: M
authors.lastname: Al Mutairi
authors.forename: Omar
authors.initials: O
authors.lastname: Tamimi
authors.forename: Ali
authors.initials: A
authors.lastname: Alakhfash
authors.forename: Mostafa
authors.initials: M
authors.lastname: Abolfotouh
authors.forename: Fahad
authors.initials: F
authors.lastname: Alhabshan
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000401:mortality; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D018633:Pulmonary Atresia / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D019233:Retreatment; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia; D013997:Time Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography; D054088:Ventricular Septum / Q000000981:diagnostic imaging