• Effect of the balloon dilatation of pulmonary stenosis on the pulmonary artery branches growth in patients with Fallot’s tetrad

Effect of the balloon dilatation of pulmonary stenosis on the pulmonary artery branches growth in patients with Fallot’s tetrad

PAEDIATRIC SURGERY.UKRAINE.2018.2(59):41-45; DOI 10.15574/PS.2018.59.41

Maksimenko А., Dovhaliuk A., Kuzmenko J., Motrechko O., Rudenko N.
SI «Scientific and Practical Medical Centre for Paediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine», Kyiv
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Objective: to determine the efficacy of balloon dilatation of pulmonary artery stenosis as a palliative procedure for optimization of pulmonary blood flow in patients with the tetralogy of Fallot that require stage treatment.
Material and methods. During the period from January 2007 to December 2016, a balloon dilatation of pulmonary stenosis was performed in 121 patients with Fallot’s tetrad. The average age of patients was 53.5±34.2 days (from 2 days to 6 months), and the average weight was 4.1±1.1 kg (from 1.2 to 7 kg). The effect of balloon dilatation on the cyanosis, growth of valves, branches of the pulmonary artery and the left ventricle was studied.
Results. As a result of balloon dilatation of pulmonary stenosis, arterial oxygen saturation of the arterial blood increased from 81.2±11.2 (from 30 to 98)% to 93.1±6.6 (from 40 to 100)% (p<0.001). The diameter of the pulmonary valve increased from 6.4±1.2 (from 4 to 9.5) mm to 7.6±2.1 (from 4 to 15) mm (p<0.001). The Nakata index increased from 112±4.2 (from 47 to 274) mm2/m2 to 152±58 (from 59 to 436) mm2/m2. The end-diastolic index of the left ventricle increased from 30.3±9.3 (from 5 to 61) ml/m2 to 35.4±13.5 (from 12 to 73) ml/m2. Radical correction of the defect was performed in 96 (79%) patients without additional palliative interventions.
Conclusions. Balloon dilatation of pulmonary artery stenosis is an effective method of optimizing pulmonary blood flow in patients with the Fallot’s tetrad. It provides the growth of the valve, branches of the pulmonary artery, left ventricle and allows avoiding additional palliative operations in 79% of cases.
Key words: balloon pulmonary valvuloplasty, Fallot’s tetrad, endovascular surgery.

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