Pulmonary Valvulotomy under Inflow Stasis for Isolated Pulmonary Stenosis
| Autor: | Richard L. Varco, William A. Neal, Russel Lucas, Demetre M. Nicoloff, Gary W. Lyons, James H. Moller, Aldo R. Castaneda, J. Jacques Mistrot |
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| Rok vydání: | 1976 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent medicine.medical_treatment Dysplastic pulmonary valve Hemodynamics law.invention Postoperative Complications law Internal medicine Methods Cardiopulmonary bypass Humans Medicine Child Pulmonary valvulotomy business.industry Operative mortality Infant Newborn Infant Heart medicine.disease Surgery Pulmonary Valve Stenosis Valvulotomy Stenosis Child Preschool Pulmonary valve stenosis Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 21:30-37 |
| ISSN: | 0003-4975 |
| Popis: | One hundred ten patients were operated upon between 1961 and 1972 for isolated pulmonary stenosis by the inflow stasis technique. Analysis of the preoperative and postoperative clinical and catheterization data define the role of inflow stasis as an acceptable method of pulmonary valvulotomy except in relieving stenosis due to a dysplastic pulmonary valve. Patient ages ranged from 2 days to 36 years. All underwent preoperative catheterization and 69 (63%) were restudied postoperatively. Mean preoperative and postoperative peak systolic gradients were 93 and 23 mm Hg, respectively. Mean valve areas before and after operation were 0.38 and 1.10 cm2/m2. Operative mortality was 3.6% (4 patients), and there was 1 late death. Two of the dead were children 2 and 9 days old, respectively. Four patients required reoperation for residual gradients; 2 had dysplastic pulmonary valves. The overall results were excellent or good in 78%, fair in 15%, and poor in 7%. Patients with dysplatic pulmonary valves were in the poor or fair group, and it is recommended that the inflow stasis technique not be used for this type of pulmonary stenosis. The excellent surgical exposure, adequate time for valvulotomy, low morbidity, and freedom from problems of cardiopulmonary bypass are reasons for continued use of this technique for treatment of selected patients with pulmonary valve stenosis. |
| Databáze: | OpenAIRE |
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