Conflict of interest: Nothing to report.
Pediatric and Congenital Heart Disease
Predictors of reintervention in neonates with critical pulmonary stenosis or pulmonary atresia with intact ventricular septum†
Article first published online: 10 JAN 2012
Copyright © 2011 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 79, Issue 4, pages 659–664, 1 March 2012
How to Cite
Shaath, G., Al Mutairi, M., Tamimi, O., Alakhfash, A., Abolfotouh, M. and Alhabshan, F. (2012), Predictors of reintervention in neonates with critical pulmonary stenosis or pulmonary atresia with intact ventricular septum. Cathet. Cardiovasc. Intervent., 79: 659–664. doi: 10.1002/ccd.23320
- Issue published online: 17 FEB 2012
- Article first published online: 10 JAN 2012
- Accepted manuscript online: 27 SEP 2011 11:16AM EST
- Manuscript Accepted: 17 JUL 2011
- Manuscript Revised: 20 JUN 2011
- Manuscript Received: 16 APR 2011
- cardiovascular intervention;
- balloon valvuloplasty;
- radio frequency perforation
Objectives: Describe the short and midterm outcome and to determine the predictors of reintervention in neonates with critical pulmonary stenosis (PS) or pulmonary atresia with intact ventricular septum (PA/IVS). Background: The transcatheter intervention for critical PS and PA/IVS resulted in improvement in the patient's survival and the quality of life. The procedure is not free of complications and there is still a significant rate of reintervention. Method: All neonates with critical PS or PA/IVS who underwent interventional cardiac catheterization between November 2004 and January 2009 were reviewed retrospectively. We performed a comparison between those who required reintervention and those who did not, to identify the predictors of reintervention. Results: Forty-three neonates were included, 23 (53.5%) had critical PS and 20 (46.5%) had PA/IVS. Twenty-six patients (60%) were males, the mean age was 11 ± 8 days, and the mean weight was 3.2 ± 0.6 kg. Two patients died (4.6%). The mean follow-up period was 19 ± 13 months for 42 patients. Fifteen patients (36%) required reintervention, 11 of them (73%) had PA/IVS, and 4 (27%) had critical PS. Reintervention was more in patients with PA/IVS than those with critical PS (P = 0.003). Other predictors for reintervention included hospital stay ≥ 7.5 days (P = 0.001) and tricuspid valve regurgitation peak gradient in day one post first intervention (TR1) ≥ 43 mm Hg (P = 0.03). Conclusion: Interventional cardiac catheterization shows favorable outcome for patients with critical PS and PA/IVS. Predictors for reintervention included the diagnosis of PA/IVS, hospital stay ≥7.5 days after first intervention and TR1 gradient ≥ 43 mm Hg. © 2011 Wiley Periodicals, Inc.