Balloon Dilatation of Right Ventricle to Pulmonary Artery Conduit Stenosis in Children

  • Y. Kuzmenko Ukrainian children’s cardiac center (Kyiv)
  • M. Radchenko Ukrainian children’s cardiac center (Kyiv)
  • O. Motrechko Ukrainian children’s cardiac center (Kyiv)
  • M. Slychko Ukrainian children’s cardiac center (Kyiv)
  • A. Avetyan Shupyk national medical academy of postgraduate education (Kyiv); Ukrainian children’s cardiac center (Kyiv)
  • A. Dovgalyuk Ukrainian children’s cardiac center (Kyiv)
Keywords: conduit, balloon dilatation, endovascular interventions, congenital heart disease, cardiac catheterization

Abstract

Materials and methods. The paper presents the retrospective analysis of information on 70 patients, which had balloon dilatation of RV-PA conduit stenosis over the period from January 1, 2013 to December 31, 2018 in the Ukrainian children’s cardiac centre.

Results. There were 70 patients who underwent successful balloon dilatation of RV-PA conduit. The mean age at the time of balloon dilatation was 10.5±6.5 (0.25-17) years, the mean weight was 39±20 (3.85-95) kg. According to cardiac catheterization results, RV-PA mean systolic pressure before balloon dilatation was 49±15 (10.5–100) mm Hg, after balloon dilatation – 31±13 (5-83) mm Hg. Reduction of RV-PA systolic pressure gradient was reported in 64 (91%) patients. The mean interval before the next reintervention after conduit stenosis balloon dilatation was 19±10 (0.5–64) months. The median range of follow-up after conduit stenosis balloon dilation is 38.5 (3-75) months. Further follow-up observations showed that 24 (34%) patients did not require any reinterventions, while 45 (64%) required reinterventions. Repeated balloon dilatation of conduit stenosis was carried out in 4 (5.7%) patients, while 41 (58%) patients had conduit replacement within 1.6 years after balloon dilatation.

Conclusion. Balloon dilatation of RV-PA conduit is an effective procedure that reduces systolic gradient of stenotic conduit in children in 91% cases and allows delaying the operation for conduit replacement by a mean of 1.6 years.

References

  1. Hainstock MR, Marshall AC, Lock JE, McElhinney DB. Angioplasty of obstructed homograft conduits in the right ventricular outflow tract with ultra-noncompliant balloons: assessment of therapeutic efficacy and conduit tears. Circ Cardiovasc Interv. 2013;6:671–9. https://doi.org/10.1161/CIRCINTERVENTIONS.112.000073
  2. Jeong HI, Song J, Choi EY, Kim SH, Huh J, Kang IS, et al. How Long Can the Next Intervention Be Delayed after Balloon Dilatation of Homograft in the Pulmonary Position? Korean Circ J. 2017 Sep;47(5):786–93. https://doi.org/10.4070/kcj.2017.0033
  3. Kuzmenko YuL, Maksimenko AV, Dovgalyuk AA, Radchenko MP, Motrechko OO, Rudenko NM. [Endovascular pulmonary artery restenosis treatment after Tetralogy of Fallot surgical correction]. Cardiovascular Surgery Herald. 2017;2(28):53–5. Ukrainian.
  4. Gu Y, Jin M, Wang XF, Guo BJ, Ding WH, Wang ZY, et al. Balloon Angioplasty as a Modality to Treat Children with Pulmonary Stenosis Secondary to Complex Congenital Heart Diseases. Chin Med J (Engl). 2017 Dec 5;130(23):2793–801. https://doi.org/10.4103/0366-6999.215715
  5. Grossman&Baim’s Cardiac catheterization, angiography, and intervention. Moscucci M, editor. 8th edition. Philadelphia: LWW;2013. p. 842–7.
Published
2019-03-11
How to Cite
1.
Kuzmenko Y, Radchenko M, Motrechko O, Slychko M, Avetyan A, Dovgalyuk A. Balloon Dilatation of Right Ventricle to Pulmonary Artery Conduit Stenosis in Children. ujcvs [Internet]. 2019Mar.11 [cited 2024Dec.21];(1 (34):27-0. Available from: http://cvs.org.ua/index.php/ujcvs/article/view/6
Section
CONGENITAL HEART DEFECTS