Interventional catheterisation. Opening up I: The ventricular outflow tracts and great arteries

Heart

Volumn 83, Issue 1, 2000, Pages 111-115

  Gibbs, John L ^a  

^a Yorkshire Heart Centre   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

AORTA COARCTATION; AORTA SUBVALVULAR STENOSIS; ARTICLE; AUTORADIOGRAPHY; BALLOON DILATATION; HEART CATHETERIZATION; HEART RIGHT VENTRICLE OUTFLOW TRACT OBSTRUCTION; PRIORITY JOURNAL; PULMONARY VALVE INSUFFICIENCY; PULMONARY VALVE STENOSIS; VALVULOTOMY;

AORTIC COARCTATION; BALLOON DILATATION; CONSTRICTION, PATHOLOGIC; HEART CATHETERIZATION; HEART VALVE DISEASES; HUMANS; LASER SURGERY; PULMONARY ARTERY; PULMONARY ATRESIA; PULMONARY VALVE STENOSIS; VENTRICULAR OUTFLOW OBSTRUCTION;

EID: 0034067151     PISSN: 13556037     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (20)

1. 1. Allen HD, Beekman RH, Garson A, et al. Pediatric therapeutic cardiac catheterisation. A Statement for healthcare professionals from the Council on Cardiovascular Disease in the Young, American Heart Association. Circulation 1998;97:609-25. An American consensus statement on various aspects of interventional catheterisation in congenital heart disease: who should be doing it, which type of centres should be involved in training, guidelines on skill maintenance, which procedures are widely accepted and which are still controversial, and a brief appraisal of many (but not all) devices in use in the USA at present. A useful, well balanced guide, with only one or two procedures recently pioneered in Europe but not yet employed in the US left uncovered.
2. 2. McCrindle BW. Independent predictors of long term results after balloon pulmonary valvuloplasty. Valvuloplasty and angioplasty of congenital anomalies (VACA) registry. Circulation 1994;89:1751-9. Multicentre results from 533 patients. Major factor in predicting successful procedure was size of balloon.
3. 3. Fawzy ME, Galal O, Dunn B, et al. Regression of infundibular pulmonary stenosis after successful balloon pulmonary valvuloplasty in adults. Cathet Cardiovasc Diagn 1990;21:77-81. 22 adults, all with some degree of infundibular as well as valvar stenosis. In all cases the gradient fell further with follow up, showing that adults behave like children in terms of regression of residual infundibular stenosis after relief of fixed obstruction at valve level.
4. 4. Stumper O, Piechaud JF, Bonhoeffer P, et al. Pulmonary balloon valvuloplasty in the palliation of complex cyanotic heart disease. Heart 1996;76:363-6.
5. 5. Gibbs JL, Uzun O, Blackburn MEC, et al. Right ventricular outflow stent implantation: an alternative to palliative surgical relief of infundibular pulmonary stenosis. Heart 1997;77:176-9.
6. 6. Sluysmans T, Neven B, Rubay J, et al. Early balloon dilatation of the pulmonary valve in infants with tetralogy of Fallot: risks and benefits. Circulation 1995;91:1506-11. Following on from earlier pioneering studies in the UK, this study describes the effect on cyanosis as well as looking at pulmonary artery growth after balloon dilatation of the outflow tract in tetralogy. It confirmed initial feelings that this is a surprisingly safe procedure and can offer excellent palliation in the minority of patients where surgical repair does not seem immediately appropriate.
7. 7. Gibbs JL, Blackburn ME, Uzun O, et al. Laser valvotomy with balloon valvoplasty for pulmonary atresia with intact ventricular septum: five years' experience. Heart 1997;77:225-8.
8. 8. Kan JS, Marvin WJ Jr, Bass JL, et al. Balloon angioplasty - branch pulmonary artery stenosis: results from the valvuloplasty and angioplasty of congenital anomalies registry. Am J Cardiol 1990;65:798-801. 182 procedures in 156 patients from 27 centres. Angiographic improvement in appearance of stenosis in most cases but proximal pulmonary artery pressure fell from mean of 69 (25) mm Hg to only 63 (24) mm Hg. On top of that there were complications in 21 cases and five deaths because of pulmonary artery rupture, paradoxical embolism, low cardiac output or cardiac arrest.
9. 9. O'Laughlin MP, Perry SB, Lock JE, et al. Use of endovascular stents in congenital heart disease. Circulation 1991;83:1923-39.
10. 10. Nakanishi T, Matsumoto Y, Seguchi Mnakazawa M, et al. Balloon angioplasty for postoperative pulmonary artery stenosis in transposition of the great arteries. J Am Coll Cardiol 1993;22:859-66. 28 patients. At least 50% fall in gradient achieved in about half the patients, with one non-fatal pulmonary artery rupture and three aneurysmal dilatations of pulmonary artery. Does not make the technique sound very rewarding in this setting.
11. 11. Powell AJ, Lock JE, Keane JF, et al. Prolongation of RV-PA conduit life by percutaneous stent implantation: intermediate term results. Circulation 1995;92:3282-8. 44 patients with obstructed conduits (either homografts or other bioprostheses). Freedom from redo surgery was 65% at 30 months. Nine patients needed repeat dilatation or repeat stenting and stent fracture occurred in seven cases (thought to be related to the uneven stresses on stents in conduits).
12. 12. Justo RN, McCrindle BW, Benson LN, et al. Aortic valve regurgitation after surgical versus percutaneous balloon valvotomy for congenital aortic valve stenosis. Am J Cardiol 1996;77:1332-8. 187 patients who had either surgical or percutaneous valvotomy. Not randomised and not perfectly matched groups of patients either, but no significant difference between the two groups in terms of reduction in gradient or development or progression of aortic regurgitation.
13. 13. Moore P, Egito E, Mowrey H, et al. Midterm results of balloon dilatation of congenital aortic stenosis: predictors of success. J Am Coll Cardiol 1996;27:1257-63. 148 children aged older than 1 month, with 95% eight year survival, 75% free from reintervention at four years and 50% at eight years. Results tend to look more favourable when neonates are excluded, as in this study.
14. 14. Sreeram N, Kitchiner D, Williams D, et al. Balloon dilatation of the aortic valve after previous surgical valvotomy: immediate and follow up results. Br Heart J 1994;71:558-60. 22 cases, results appeared just as rewarding as in patients who had not undergone previous treatment.
15. 15. Anon. Percutaneous balloon aortic valvuloplasty: acute and 30 day follow up results in 674 patients from the NHLBI balloon valvuloplasty registry. Circulation 1991;84:2383-97. A multicentre report. Adults only (the majority were over 70 years old); 86% survival at 30 days with appreciable morbidity (stroke, vascular damage) but 75% of survivors appeared to benefit to some extent with regard to exercise tolerance.
16. 16. Lababidi Z, Weinhaus L, Stoeckle H, et al. Transluminal balloon dilatation for discrete subaortic stenosis. Am J Cardiol 1987;59:423-5.
17. 17. Rao PS. Should balloon angioplasty be used instead of surgery for native aortic coarctation? Br Heart J 1995;74:578-9. An editorial presenting one American view of ballooning native coarctation from neonates to adults. From a well known protagonist of the technique, suggests that balloon angioplasty has similar results to surgery in terms of relieving stenosis and producing aneurysms. Should be read in conjunction with the following reference from the correspondence columns which argues that published data are by no means conclusive and could be interpreted quite differently.
18. 18. Qureshi SA, Rosenthal E. Should balloon angioplasty be used instead of surgery for native aortic coarctation? Heart 1997;77:86. See comment above.
19. 19. Fawzy ME, Sivanandam V, Galal O, et al. One to ten year follow up of balloon angioplasty of native coarctation of the aorta in adolescents and adults. J Am Coll Cardiol 1997;30:1542-6. 43 patients over the age of 15; 7% had suboptimal relief of coarctation (but responded to repeat angioplasty) and 7% developed small aortic aneurysms, although the aneurysms did not seem to increase in size over the study period. The patients all had discrete coarctation rather than tubular stenoses. The conclusion was that it is a safe and effective alternative to surgery for this particular type of coarctation. A pity there is such a paucity of reports of surgical treatment from the current generation of surgeons who appear to produce superlative results at very low risk.
20. 20. Ebeid MR, Prieto LR, Latson LA. Use of balloon expandable stents for coarctation of the aorta: initial results and intermediate follow up. J Am Coll Cardiol 1997;30:1847-52. Small study of a new technique, the idea being that using a stent avoids the need to use an oversized balloon and therefore might reduce the risk of aneurysm formation. No aneurysms, good results in terms of relief of obstruction, but only nine patients, so early days yet.