RT Journal Article
SR Electronic
T1 Use of balloon dilatation to treat supravalvar pulmonary stenosis developing after anatomical correction for complete transposition.
JF British Heart Journal
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 151
OP 155
DO 10.1136/hrt.64.2.151
VO 64
IS 2
A1 A Saxena
A1 L V Fong
A1 B C Ogilvie
A1 B R Keeton
YR 1990
UL http://heart.bmj.com/content/64/2/151.abstract
AB Eight balloon dilatations were performed in five patients (aged from 10 to 37 months) in whom supravalvar pulmonary stenosis developed after anatomical correction for complete transposition. The ratio of the maximum diameter of the inflated balloon to the narrowest pulmonary arterial diameter varied from 1.6 to 3.3. In three patients with an initial ratio of less than or equal to 2 dilatation was repeated with a larger balloon. The right ventricular systolic pressure ranged from 0.70 to 1.25 of the simultaneously measured femoral arterial systolic pressure. The major stenosis was in the main pulmonary artery in four patients and at the pulmonary arterial bifurcation in one. After balloon angioplasty in the four patients there was no significant improvement in the ratio of right ventricular to femoral arterial systolic pressure or in the angiographic appearance. There was no change in the pressure ratio after angioplasty in the patient who had a major stenosis of the pulmonary arterial bifurcation and mild main pulmonary artery narrowing. There seemed to be a slight angiographic improvement in the bifurcation stenosis but at restudy two months later the angiographic improvement had disappeared. Balloon angioplasty of supravalvar pulmonary stenosis developing after anatomical correction for complete transposition was not successful in eight procedures. This lack of success may be attributable to a small pulmonary annulus with consequent multiple levels of stenosis and distortion of the main pulmonary artery.