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Balloon Angioplasty as a Modality to Treat Children with pulmonary stenosis Secondary to Complex Congenital Heart Diseases

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Chinese Medical Journal 2017年第23期130卷 2793-2801页

作者： Yan Gu Mei Jin Xiao-Fang Wang Bao-Jing Guo Wen-Hong Ding Zhi-Yuan Wang Ya-Hui Zhang Department of Pediatric Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

Background： pulmonary stenosis is common in children with complex congenital heart diseases. Proper management of this problem, especially postoperatively, is still controversial. This study was designed to assess the rate and determinants of success or failure of balloon angioplasty for such lesions. Methods： Clinical and hemodynamic data from 40 pediatric patients （24 boys and 16 girls） with complex congenital heart diseases who underwent balloon angioplasty were reviewed retrospectively from January 2012 to December 2016. Patients were divided into four groups according to the site of stenosis, which included pulmonary valve stenosis （PVS）, valved conduit stenosis, pulmonary artery stenosis （PAS）, and supravalvular pulmonary stenosis （SVPS）. Success rates were calculated according to defined criteria for initial success and favorable clinical impacts, and comparison between the successful subgroup and the unsuccessful subgroups was analyzed. Results： Grouped by the site of stenosis, initial success rates varied from 40.0% to 52.4% with the greatest success being seen in the PVS group, followed by the PAS group and SVPS group. In the PVS group and the PAS group, there was no statistical difference among age at dilation, postoperative interval, balloon/stenosis ratio, or pressure gradient predilation between the successful and the unsuccessful subgroups. Favorable clinical impacts included success rates of balloon angioplasty in the SVPS group, which was best （100%）, followed by the PVS group （90.9%） and the PAS group （85.7%）. There were a total of two transient complications （5.0%）. Conclusions： Balloon angioplasty was proven to be a safe and useful modality in children with complex congenital heart diseases and postoperative pulmonary stenosis, which should be the initial therapeutic modality in selected patients.

关键词： Balloon Angioplasty Complex Congenital Heart Disease pulmonary stenosis

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Lutembacher Syndrome and Rheumatic pulmonary stenosis

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South China Journal of Cardiology 2008年第1期9卷 49-50页

作者：池菊芳郭航远杨彪 Department of Cardiology Shaoxing People's Hospital The First Affiliated Hospital of Shaoxing University

We discribed a case of a 55-yr-old woman diagnosed with Lutembacher syndrome and rheumatic pulmonary stenosis. Congenital atrial septal defect was found in age 7 and rheumatic fever in age 34. As the patient developed pulmonary hypertension with calcified mitral valve leaflet and pulmonary stenosis so surgery was not indicated. So the patient was managed by medical therapy alone.

关键词： Lutembacher syndrome atrial septal defect pulmonary stenosis

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Estimating pressure gradients by auscultation:How technology(echocardiography)can help improve clinical skills

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World Journal of Cardiology 2017年第8期9卷 693-701页

作者： Rohini L Kadle Colin KL Phoon Division of Pediatric Cardiology Hassenfeld Children’s Hospital of New York at NYU LangoneFink Children’s CenterNew YorkNY 10016United States

AIM To extend our previously-published experience in estimating pressure gradients(PG) via physical examination in a large patient cohort. METHODS From January 1, 1997 through December 31, 2009, an attending pediatric cardiologist compared clinical examination(EXAM) with Doppler-echo(ECHO), in 1193 patients with pulmonic stenosis(PS, including tetralogy of Fallot), aortic stenosis(AS), and ventricular septal defect(VSD). EXAM PG estimates were based primarily on a murmur's pitch, grade, and length. ECHO peak instantaneous PG was derived from the modified Bernoulli equation. Patients were 0-38.4 years old(median 4.8).RESULTS For all patients, EXAM correlated highly with ECHO: ECHO = 0.99(EXAM) + 3.2 mm Hg; r = +0.89; P 10 years in *** Clinical examination can accurately estimate PG in PS, AS, or VSD. Continual correlation of clinical findings with echocardiography can lead to highly accurate diagnostic skills.

关键词： Physical examination Ventricular septal defect Clinical skills Echocardiography Aortic stenosis pulmonary stenosis

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