Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1990 Nov;64(5):321–324. doi: 10.1136/hrt.64.5.321

Operative findings after percutaneous pulmonary balloon dilatation of the right ventricular outflow tract in tetralogy of Fallot.

S A Battistessa 1, A Robles 1, M Jackson 1, S Miyamoto 1, R Arnold 1, R McKay 1
PMCID: PMC1216811  PMID: 2245111

Abstract

Since 1983 percutaneous balloon dilatation of the right ventricular outflow tract has been performed as an alternative to surgical palliation in selected cases of tetralogy of Fallot at the Royal Liverpool Children's Hospital. From 31 December 1984 to 31 December 1988, 27 of these patients underwent subsequent surgical correction. Age at operation ranged from 7 to 58 months (median 2.7 years). The mean interval between balloon dilatation and correction was 15.6 months (range 3-39 months). Two patients had a systemic pulmonary shunt operation performed before dilatation and a further five required one afterwards. Overall 20 (74%) patients had some anatomical alteration as the result of balloon dilatation, while in seven (26%) there was no discernible change in the right ventricular outflow tract. There was no consistent relation between the ratio of balloon size to pulmonary annulus diameter and the morphological findings. Balloon dilatation may obviate the need for systemic-pulmonary shunt at the expense of some structural damage, particularly to the posterior cusp. The present data suggest that dilatation does not bring about growth of the annulus to such an extent that transannular patch is no longer needed at intracardiac repair.

Full text

PDF

Images in this article

322Figure 1
on p.322
322Figure 2
on p.322
323Figure 3
on p.323

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Deanfield J. E., Ho S. Y., Anderson R. H., McKenna W. J., Allwork S. P., Hallidie-Smith K. A. Late sudden death after repair of tetralogy of Fallot: a clinicopathologic study. Circulation. 1983 Mar;67(3):626–631. doi: 10.1161/01.cir.67.3.626. [DOI] [PubMed] [Google Scholar]
  2. Fontes V. F., Sousa J. E., Esteves C. A., Silva M. V., Cano M. N., Maldonado G. Pulmonary valvoplasty--experience of 100 cases. Int J Cardiol. 1988 Dec;21(3):335–342. doi: 10.1016/0167-5273(88)90110-6. [DOI] [PubMed] [Google Scholar]
  3. Kan J. S., White R. I., Jr, Mitchell S. E., Gardner T. J. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med. 1982 Aug 26;307(9):540–542. doi: 10.1056/NEJM198208263070907. [DOI] [PubMed] [Google Scholar]
  4. Lababidi Z., Wu J. R. Percutaneous balloon pulmonary valvuloplasty. Am J Cardiol. 1983 Sep 1;52(5):560–562. doi: 10.1016/0002-9149(83)90026-7. [DOI] [PubMed] [Google Scholar]
  5. Lamb R. K., Qureshi S. A., Arnold R. Pulmonary artery tear following balloon valvoplasty in Fallot's tetralogy. Int J Cardiol. 1987 Jun;15(3):347–349. doi: 10.1016/0167-5273(87)90341-x. [DOI] [PubMed] [Google Scholar]
  6. Lock J. E., Niemi T., Einzig S., Amplatz K., Burke B., Bass J. L. Transvenous angioplasty of experimental branch pulmonary artery stenosis in newborn lambs. Circulation. 1981 Nov;64(5):886–893. doi: 10.1161/01.cir.64.5.886. [DOI] [PubMed] [Google Scholar]
  7. Oku H., Shirotani H., Ohnishi H. Two-cusp plasty for the right ventricular outflow tract in complete repair of tetralogy of Fallot. Ann Thorac Surg. 1988 Jan;45(1):97–98. doi: 10.1016/s0003-4975(10)62409-5. [DOI] [PubMed] [Google Scholar]
  8. Pacifico A. D., Sand M. E., Bargeron L. M., Jr, Colvin E. C. Transatrial-transpulmonary repair of tetralogy of Fallot. J Thorac Cardiovasc Surg. 1987 Jun;93(6):919–924. [PubMed] [Google Scholar]
  9. Parsons J. M., Ladusans E. J., Qureshi S. A. Growth of the pulmonary artery after neonatal balloon dilatation of the right ventricular outflow tract in an infant with the tetralogy of Fallot and atrioventricular septal defect. Br Heart J. 1989 Jul;62(1):65–68. doi: 10.1136/hrt.62.1.65. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Qureshi S. A., Kirk C. R., Lamb R. K., Arnold R., Wilkinson J. L. Balloon dilatation of the pulmonary valve in the first year of life in patients with tetralogy of Fallot: a preliminary study. Br Heart J. 1988 Sep;60(3):232–235. doi: 10.1136/hrt.60.3.232. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. RUBIO-ALVAREZ V., LIMON R., SONI J. Valvulotomias intracardiacas por medio de un cateter. Arch Inst Cardiol Mex. 1953 Apr;23(2):183–192. [PubMed] [Google Scholar]
  12. Rey C., Marache P., Matina D., Mouly A. Valvuloplastie transluminale percutanée des sténoses pulmonaires. A propos de 24 cas. Arch Mal Coeur Vaiss. 1985 May;78(5):703–710. [PubMed] [Google Scholar]
  13. Ring J. C., Kulik T. J., Burke B. A., Lock J. E. Morphologic changes induced by dilation of the pulmonary valve anulus with overlarge balloons in normal newborn lambs. Am J Cardiol. 1985 Jan 1;55(1):210–214. doi: 10.1016/0002-9149(85)90330-3. [DOI] [PubMed] [Google Scholar]
  14. Semb B. K., Tjönneland S., Stake G., Aabyholm G. "Balloon valvulotomy" of congenital pulmonary valve stenosis with tricuspid valve insufficiency. Cardiovasc Radiol. 1979 Nov;2(4):239–241. doi: 10.1007/BF02552069. [DOI] [PubMed] [Google Scholar]
  15. Tynan M., Baker E. J., Rohmer J., Jones O. D., Reidy J. F., Joseph M. C., Ottenkamp J. Percutaneous balloon pulmonary valvuloplasty. Br Heart J. 1985 May;53(5):520–524. doi: 10.1136/hrt.53.5.520. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES