title: First-in-Human Percutaneous Balloon Pulmonary Valvuloplasty Under Echocardiographic Guidance Only.
abstract: OBJECTIVE
  The objective of this study was to assess the feasibility of percutaneous balloon pulmonary valvuloplasty (PBPV) under echocardiographic guidance only.
  
  
  METHODS
  PBPV has become the preferred choice for pulmonary valve stenosis (PS). We report the first-in-human successful PBPV under only echocardiography guidance for isolated PS.
  
  
  METHODS
  From March 2013 to December 2014, 34 patients with congenital PS underwent PBPV with echocardiography as the only imaging modality in the ordinary operation room or catheter lab. Outpatient follow-up including chest radiography, electrocardiography, and transthoracic echocardiography (TTE) was conducted at 1, 3, 6, and 12 months.
  
  
  RESULTS
  All 34 patients successfully underwent PBPV under echocardiography guidance without radiation and contrast agent. The pulmonic transvalvular pressure gradient dropped from 62.8 ± 10.1 mm Hg to 14.7 ± 4.2 mm Hg measured on catheterization (P < .05). The balloon diameter/pulmonary annulus diameter ratio was 1.34 ± 0.07. Slight regurgitation of the pulmonary valve occurred in five patients and mild pulmonary regurgitation occurred in one patients. The pulmonic transvalvular pressure gradient measured on TTE 12 months after the procedure was 14.1 ± 4.6 mm Hg. No pericardial effusion and peripheral vascular complications occurred.
  
  
  CONCLUSIONS
  This study demonstrated that PBPV can be successfully performed under only echocardiography guidance and appears safe and effective while avoiding radiation and contrast agent use.
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Shou-Zheng
authors.initials: SZ
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Ou-Yang
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Sheng-Shou
authors.initials: SS
authors.lastname: Hu
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Kun-Jing
authors.initials: KJ
authors.lastname: Pang
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Feng-Wen
authors.initials: FW
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Surgery, National Center for Cardiovascular Disease, China & Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
authors.forename: Xiang-Bin
authors.initials: XB
authors.lastname: Pan
mesh_terms: D000293:Adolescent; D063126:Balloon Valvuloplasty / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002681:China; D004452:Echocardiography / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D061214:Patient Safety; D011237:Predictive Value of Tests; D011664:Pulmonary Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011665:Pulmonary Valve Insufficiency / Q000209:etiology; D011666:Pulmonary Valve Stenosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods*
keywords: Balloon Pulmonary Valvuloplasty; Echocardiography; Percutaneous Intervention; Pulmonary Valve Stenosis