Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions.
OBJECTIVE
To determine the feasibility and safety of the Conquest Pro wire as an alternative to radiofrequency wire for perforation of atretic pulmonary valve and subsequent balloon dilatation and patent ductus arteriosus stenting in patients with pulmonary atresia with intact ventricular septum.


BACKGROUND
Radiofrequency valvotomy and balloon dilatation has become the standard of care for pulmonary atresia with intact ventricular septum in many institutions today.


METHODS
We report eight consecutive patients in whom we used the Conquest Pro coronary guidewire, a stiff wire normally reserved for revascularisation of coronary lesions with chronic total occlusion, for perforation of atretic pulmonary valve and subsequent balloon dilatation, and stenting of the patent ductus arteriosus.


RESULTS
Perforation of atretic pulmonary valve was successful in seven out of eight cases. Radiofrequency valvotomy was employed after failure of perforation by the Conquest Pro wire in one case where the right ventricular outflow tract was broad based and tapered towards the pulmonary valve, and was heavily trabeculated. Failure of the Conquest Pro wire to perforate the pulmonary valve plate was mainly attributed by the failure to engage the wire at the correct position.


CONCLUSIONS
The Conquest Pro wire for perforation and subsequent interventions in the more straightforward cases of pulmonary atresia with intact ventricular septum is effective and safe, simplifying the entire procedure. However, the radiofrequency generator and wires remain essential tools in the paediatric interventional catheter laboratory.
Department of Pediatric Cardiology, National Heart Institute, Kuala Lumpur, Malaysia. mazeni@ijn.com.my
Mazeni
M
Alwi
Rahmat R
RR
Budi
Marhisham Che
MC
Mood
Ming C
MC
Leong
Hasri
H
Samion
D063126:Balloon Valvuloplasty / Q000295:instrumentation / Q000379:methods; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D062906:Cardiac Catheters; D015331:Cohort Studies; D005240:Feasibility Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018633:Pulmonary Atresia / Q000601:surgery*; D011664:Pulmonary Valve / Q000601:surgery*; D016896:Treatment Outcome