Long-term outcomes up to 25 years following balloon pulmonary valvuloplasty: A multicenter study

Autor: Craig J. Byrum, Glenn T. Leonard, Rachel L. Hansen, Matthew Egan, Iman Naimi, Hongyue Wang, Frank C. Smith, Daniel A. Kveselis, Nader Atallah, Rajiv Devanagondi
Rok vydání: 2018
Předmět:
Adult
Balloon Valvuloplasty
Male
medicine.medical_specialty
Time Factors
Adolescent
New York
Pulmonary insufficiency
030204 cardiovascular system & hematology
Single Center
Balloon
Severity of Illness Index
03 medical and health sciences
Young Adult
0302 clinical medicine
Risk Factors
030225 pediatrics
Internal medicine
Long term outcomes
Medicine
Humans
Radiology
Nuclear Medicine and imaging
Child
Aged
Univariate analysis
Pulmonary Valve
business.industry
Incidence
Body Weight
Hemodynamics
Infant
Newborn
Infant
General Medicine
Recovery of Function
Middle Aged
medicine.disease
Pulmonary Valve Insufficiency
Pulmonary Valve Stenosis
Stenosis
Treatment Outcome
Multicenter study
Child
Preschool
Pediatrics
Perinatology and Child Health
Pulmonary valve stenosis
Cardiology
Surgery
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Congenital heart diseaseREFERENCES. 14(6)
ISSN: 1747-0803
Popis: Objective Evaluate long-term outcomes following balloon pulmonary valvuloplasty (BPV) for pulmonary stenosis (PS). Background Long-term data following BPV is limited to small, single center studies. Methods BPV from April 12, 1985 to January 7, 2015 from three centers were included. Outcomes studied were ≥ moderate PI by echocardiogram and residual PS ≥ 40 mm Hg. Risk factors for ≥ moderate PI, residual PS, and repeat intervention were assessed by univariate and multivariate analysis. Results Among 254 patients, mean age at BPV was 3.8 years (range 1 day-67 years), initial PS catheter gradient was 56 mm Hg (IQR 40-70), 19% had critical PS, and 9% had genetic syndromes. Mean follow-up duration was 7.5 years (maximum 25 years). Sixty-nine (29%) had ≥ moderate PI, 41 patients (17%) had residual PS > 40 mm Hg, and 31 (13%) had re-intervention. In univariate analysis, younger age, lower weight, greater initial PS gradient, greater initial RV/systemic pressure ratio, critical PS, and longer follow-up duration were associated with ≥ moderate PI. Greater initial PS gradient was associated with long-term residual PS or repeat intervention. In multivariate analysis, greater initial gradient and lower weight were independently associated with > moderate PI and greater initial PS gradient and genetic abnormality were independently associated with residual PS and repeat intervention. Conclusion Smaller patients with greater initial PS were more likely to develop significant long-term PI. Patients with greater initial PS and genetic abnormalities were more likely to have residual PS or require repeat intervention following BPV.
Databáze: OpenAIRE
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