title: Effects of Balloon Pulmonary Valvuloplasty as Preoperative Palliation for Tetralogy of Fallot.
abstract: OBJECTIVE
  We investigated the effect of balloon pulmonary valvuloplasty (BPV) as a palliative procedure for patients with tetralogy of Fallot (TOF).
  
  
  METHODS
  This was a retrospective single-center study conducted between 2008 and 2014. We classified patients into three groups according to palliation: treatment with BPV (group I), with a Blalock-Taussig shunt (group II), and with infundibulectomy (group III). The growth of the pulmonary valve (PV) annulus and need for transannular patching (TAP) during total correction were compared between groups.
  
  
  RESULTS
  Forty-eight patients were enrolled: 31, 10, and 7 in groups I, II, and III, respectively. The mean ages at palliation were 26.3 ± 23.6, 21.5 ± 16.4, and 15.2 ± 4.2 days in groups I, II, and III, respectively (P = .867). The success rate of BPV was 90.3%. The initial PV z-score before palliation did not differ between groups I, II, and III (-3.14 ± 1.44, -3.84 ± 1.47, and -3.71 ± 1.68; P = .494); the preoperative PV z-score before total correction was larger in group I than in group II (-1.19 ± 1.14 and -3.05 ± 1.19; P = .001), and also larger in group III than in group II (group III: -1.10 ± 0.90; P = .003). The change in pulse oxygen saturation differed significantly between the three groups (P = .031), particularly between groups I and II (P = .010), and the change in PV z-score was greater in groups I and III than in group II (P < .001). TAP during total correction was performed in 29.0%, 90.0%, and 16.7% of groups I, II, and III, respectively (P = .001; group I vs. II, P = .001; group II vs. III, P = .008).
  
  
  CONCLUSIONS
  BPV was an effective and safe palliation that increased pulmonary blood flow and promoted growth of the PV annulus in selected symptomatic newborns with TOF.
authors.affiliation: Heart Center, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Geena
authors.initials: G
authors.lastname: Kim
authors.affiliation: Heart Center, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Gil Ho
authors.initials: GH
authors.lastname: Ban
authors.affiliation: Heart Center, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Hyoung Doo
authors.initials: HD
authors.lastname: Lee
authors.affiliation: Heart Center, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Si Chan
authors.initials: SC
authors.lastname: Sung
authors.affiliation: Heart Center, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Hyungtae
authors.initials: H
authors.lastname: Kim
authors.affiliation: Heart Center, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Choi
mesh_terms: D063126:Balloon Valvuloplasty / Q000009:adverse effects; D058366:Blalock-Taussig Procedure / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care / Q000379:methods*; D011300:Preoperative Care; D011652:Pulmonary Circulation; D011664:Pulmonary Valve / Q000254:growth & development / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Balloon Valvuloplasty; Child; Tetralogy of Fallot