title: Evaluating the risk factors of reintervention of neonates with PA/IVS and CPS/IVS after PBPV as initial intervention method.
abstract: To analyze the clinical features, immediate and short-term outcome of percutaneous balloon pulmonary valvuloplasty (PBPV) of neonates with pulmonary atresia with intact ventricular septum (PA/IVS) or critical pulmonary stenosis with intact ventricular septum (CPS/IVS) who underwent PBPV as initial intervention methods to evaluate the risk factors of reintervention.
  
  
  
  Thirty-eight neonates with PA/IVS or CPS/IVS admitted to Shanghai Xinhua Hospital between June 2009 and November 2014 who underwent PBPV as initial procedures were respectively studied. We analyzed their clinical features, the immediate and short-term outcome of PBPV, and evaluated the risk factors for reintervention.
  
  
  
  Thirty-eight neonates with PA/IVS and CPS/IVS who underwent PBPV as initial procedures were included in our study with a mean age of 13±8 days. Among the 12 patients who underwent reintervention, 7 patients had PA/IVS (64%) and 5 had CPS/IVS (36%). Patients with PA/IVS (p=0.005), small pulmonary valve diameter (p=0.035), and bad pulmonary valve development were important risk factors. The immediate and short-term outcome of PBPV was better in patients who did not need reintervention, and the peak-to-peak pulmonary transvalvular gradient in the 1st month after PBPV had the best capability in predicting reintervention with help of receiver operating characteristic curve and the logistic regression analysis. Days of prostaglandin E1 (PGE1) infusion after PBPV >5 days was also found to be a risk factor for reintervention.
  
  
  
  The short- and mid-term outcome of pulmonary valve perforation and PBPV in neonates with PA/IVS and CPS/IVS was favorable. Risk factors include PA/IVS, small pulmonary valve, bad short-term pulmonary valve development, the peak-to-peak pulmonary transvalvular gradient in the 1st month after procedure >42mmHg, and PGE1 infusion >5 days.
authors.affiliation: Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Yu Rong
authors.initials: YR
authors.lastname: Wu
authors.affiliation: Department of Statistics, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Li Na
authors.initials: LN
authors.lastname: Zhang
authors.affiliation: Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Yong Jun
authors.initials: YJ
authors.lastname: Zhang
authors.affiliation: Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Li Juan
authors.initials: LJ
authors.lastname: Xie
authors.affiliation: Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.
authors.forename: Sun
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China. Electronic address: sunkun@xinhuamed.com.cn.
authors.forename: Kun
authors.initials: K
authors.lastname: Sun
mesh_terms: D000527:Alprostadil / Q000008:administration & dosage; D063126:Balloon Valvuloplasty; D005260:Female; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018633:Pulmonary Atresia / Q000628:therapy*; D011664:Pulmonary Valve / Q000002:abnormalities; D011666:Pulmonary Valve Stenosis / Q000628:therapy*; D019233:Retreatment; D012307:Risk Factors; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D000527:Alprostadil
keywords: Critical pulmonary stenosis with intact ventricular septum; Percutaneous balloon pulmonary valvuloplasty; Pulmonary atresia with intact ventricular septum; Risk factor