Presented in part at the 8th International Conference on Pediatric Mechanic Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion held June 13–16, 2012 in Istanbul, Turkey.
Main Text Article
Transcatheter Management of Neonates With Pulmonary Atresia With Intact Ventricular Septum: A Single Center Experience From Turkey
Article first published online: 11 JAN 2013
© 2013, Copyright the Authors. Artificial Organs © 2013, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Volume 37, Issue 1, pages E56–E61, January 2013
How to Cite
Odemis, E., Ozyilmaz, I., Guzeltas, A., Erek, E., Haydin, S. and Bakır, İ. (2013), Transcatheter Management of Neonates With Pulmonary Atresia With Intact Ventricular Septum: A Single Center Experience From Turkey. Artificial Organs, 37: E56–E61. doi: 10.1111/aor.12034
- Issue published online: 11 JAN 2013
- Article first published online: 11 JAN 2013
- Manuscript Revised: OCT 2012
- Manuscript Received: JUN 2012
- Transcatheter management;
- Pulmonary atresia;
- Radiofrequency valvotomy;
Pulmonary atresia with intact ventricular septum (PAIVS) is characterized by a broad spectrum of heterogeneous morphologies. Perforation of the atretic valve, balloon dilatation, and stenting of the patent ductus arteriosus are the percutaneous techniques that are used with increasing frequency in our clinic as well. They have some advantages over surgery, including short hospital stay and short intensive care unit stay. The main goal of the primary interventional approach is to avoid surgery. However, a group of patients with PAIVS still need surgery due to poor right ventricular growth. Therefore, the final achievement of the initial percutaneous treatment strategies is still debatable. In this article, we present the early- and mid-term results of the percutaneous approach utilized at our clinic in order to investigate the final effects of interventional therapy according to initial morphology. Between May 2010 and May 2012, 15 neonates diagnosed with PAIVS underwent transcatheter intervention. Detailed echocardiographic examination focused on right ventricle size, and tricuspid valve morphology and coronary sinusoids were performed in all the patients before the intervention. Nine of the patients were boys and six were girls. The mean age was 11.40 ± 12.87 days and mean weight was 3.34 ± 0.46 kg. Only one procedure-related mortality occurred. The mean follow-up period was 10.05 ± 3.42 months (1–26 months). The mean duration of intensive care was 7.19 ± 5.14 days. The mean follow-up time was 10.05 ± 3.42 months. After this period, survival rate was 66% (10/15). Two of the patients achieved biventricular physiology after pulmonary valve perforation. Two patients still have univentricular physiology. Six patients have been followed as a one and half ventricle repair candidate. Five out of 15 patients had stent patency during 6 months of follow-up, while restenosis developed in one patient (1/5, 20%), who had undergone the Glenn operation at 5 months of age. Transcatheter management for PAIVS is a feasible, safe, and effective primary palliative treatment in newborns. Shunt surgery may be considered in cases where cyanosis occurs despite transcatheter intervention. Right ventricular size determines the type of intervention. The early outcomes can be comparable with surgical palliation. However, a group of PAIVS, particularly with severe right ventricular hypoplasia, needs surgery even after a successful primary percutaneous intervention.