ABSTRACT
Percutaneous angioplasty was performed in twenty consecutive patients, with congenital pulmonary valve stenosis. Ages ranged from eight months to thirty-two years (mean 9.5 years old). We achieved a valvular gradient dropping from 91 +/- 39 to 19 +/- 11 mm Hg (P less than 0.001) in early post angioplasty level and it was practically unchanged at three months and one year later. (19 +/- 12, 19 +/- 17 mm Hg) (P less than 0.001). Similar change was observed in the right ventricle systolic pressure which was diminished in a progressive way during the follow-up from 113 +/- 37 to 39 +/- 35 (P less than 0.001), 59 +/- 18 and 53 +/- 25 mm Hg (P less than 0.001) immediately, three months and one year later, respectively. The ratio right ventricle systolic pressure/left ventricle was diminished from 0.96 +/- 29 to 0.63 +/- 0.35 in the early post angioplasty period and later from 0.50 +/- 0.16 and 0.44 +/- 0.22 (P less than 0.001). Only one case had restenosis one year later and we repeated the angioplasty with good results. Most of the patients are asymptomatic, the pulmonary murmur features changed. We observed improvement in electrocardiographic and echocardiographic signs. One patient died of anesthetic complications. The remainder of patients did not have severe complications and they were discharged from 48 to 72 hours after angioplasty. In conclusion, valvuloplasty is an effective procedure in a short and long term basis. We considered valvuloplasty in congenital pulmonary valve stenosis the treatment of choice in this group of patients.
Subject(s)
Angioplasty, Balloon , Pulmonary Valve Stenosis/therapy , Adolescent , Adult , Child , Child, Preschool , Echocardiography , Electrocardiography , Evaluation Studies as Topic , Hemodynamics , Humans , Infant , Pulmonary Valve Stenosis/congenital , Pulmonary Valve Stenosis/physiopathologyABSTRACT
Se revisa la literatura a partir de 1901, desde la primera publicacion del bloqueo A-V congenito hasta las recientes publicaciones de diferentes autores en nuestro medio. Se agregan seis casos de la experiencia del Servicio de Cardiologia Pediatrica del CMR y tomando la referencia del estudio cooperativo de Michaelsson de los cinco factores de riesgo en el bloqueo A-V congenito, se trata de clasificar cada caso en particular, para indicar en forma definitiva el implante de marca-paso, se le dio valor de dos puntos a cada uno de los factores de riesgo y dependiendo de la calificacion de cada caso se indica el tratamiento de eleccion
