Skip to main content Accessibility help
×
Home
Hostname: page-component-5bf98f6d76-rtbc9 Total loading time: 0.451 Render date: 2021-04-21T19:42:19.652Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions

Published online by Cambridge University Press:  29 May 2012

Mazeni Alwi
Affiliation:
Department of Pediatric Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
Rahmat R. Budi
Affiliation:
Department of Pediatric Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
Marhisham Che Mood
Affiliation:
Department of Pediatric Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
Ming C. Leong
Affiliation:
Department of Pediatric Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
Hasri Samion
Affiliation:
Department of Pediatric Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
Corresponding
E-mail address:

Abstract

Objective

To determine the feasibility and safety of the Conquest Pro wire as an alternative to radiofrequency wire for perforation of atretic pulmonary valve and subsequent balloon dilatation and patent ductus arteriosus stenting in patients with pulmonary atresia with intact ventricular septum.

Background

Radiofrequency valvotomy and balloon dilatation has become the standard of care for pulmonary atresia with intact ventricular septum in many institutions today.

Methods

We report eight consecutive patients in whom we used the Conquest Pro coronary guidewire, a stiff wire normally reserved for revascularisation of coronary lesions with chronic total occlusion, for perforation of atretic pulmonary valve and subsequent balloon dilatation, and stenting of the patent ductus arteriosus.

Results

Perforation of atretic pulmonary valve was successful in seven out of eight cases. Radiofrequency valvotomy was employed after failure of perforation by the Conquest Pro wire in one case where the right ventricular outflow tract was broad based and tapered towards the pulmonary valve, and was heavily trabeculated. Failure of the Conquest Pro wire to perforate the pulmonary valve plate was mainly attributed by the failure to engage the wire at the correct position.

Conclusion

The Conquest Pro wire for perforation and subsequent interventions in the more straightforward cases of pulmonary atresia with intact ventricular septum is effective and safe, simplifying the entire procedure. However, the radiofrequency generator and wires remain essential tools in the paediatric interventional catheter laboratory.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below.

References

1. Bull, C, De Leval, M, Mercanti, C, Macartney, FJ, Anderson, RH. Pulmonary atresia and intact ventricular septum: a revised classification. Circulation 1982; 66: 266272.CrossRefGoogle ScholarPubMed
2. Justo, RN, Nykanen, DG, Williams, WG, Freedom, RM, Benson, LN. Transcatheter perforation of the right ventricular outflow tract as initial therapy for pulmonary valve atresia and intact ventricular septum in the newborn. Cathet Cardiovasc Diagn 1997; 40: 408413.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
3. Alwi, M, Choo, KK, Radzi, NAM, Samion, H, Pau, KK, Hew, CC. Concomitant stenting of the patent ductus arteriosus and radiofrequency valvotomy in pulmonary atresia with intact ventricular septum and intermediate right ventricle: early in-hospital and medium-term outcomes. J Thorac Cardiovasc Surg 2011; 141: 17; (published online January 10, 2011).CrossRefGoogle ScholarPubMed
4. Gewillig, M, Boshoff, DE, Dens, J, Merten, L, Benson, L. Stenting the neonatal duct in duct dependent pulmonary circulation: new techniques, better results. J Am Coll Cardiology 2004; 43: 107112.CrossRefGoogle ScholarPubMed
5. Humpl, T, Söderberg, B, McCrindle, BW, et al. Percutaneous balloon valvotomy in pulmonary atresia with intact ventricular septum: impact on patient care. Circulation 2003; 108: 826832.CrossRefGoogle Scholar
6. Agnoletti, G, Fiechaud, JF, Bonhoeffer, P, et al. Perforation of the atretic pulmonary valve. J Am Coll Cardiol 2003; 41: 13991403.CrossRefGoogle ScholarPubMed
7. Cheatham, JP. The transcatheter management of the neonate and infant with pulmonary atresia and intact ventricular septum. J Interven Cardiol 1998; 11: 363387.CrossRefGoogle Scholar
8. Alwi, M. Management algorithm in pulmonary atresia with intact ventricular septum. Cathet Cardiovasc Intervent 2006; 67: 679686.CrossRefGoogle Scholar
9. Qureshi, SA, Rosenthal, E, Tynan, M, Anjos, R, Baker, EJ. Transcatheter laser-assisted balloon pulmonary valve dilation in pulmonic valve atresia. Am J Cardiol 1991; 67: 428431.CrossRefGoogle ScholarPubMed
10. Latson, LA. Nonsurgical treatment of a neonate with pulmonary atresia and intact ventricular septum by transcatheter puncture and balloon dilation of the atretic valve membranous. Am J Cardiol 1991; 68: 277279.CrossRefGoogle Scholar
11. Rosenthal, E, Qureshi, SA, Chan, KC, et al. Radiofrequency-assisted balloon dilatation in patients with pulmonary valve atresia and an intact ventricular septum. Br Heart J 1993; 69: 347351.CrossRefGoogle ScholarPubMed
12. Gibbs, JL, Blackburn, ME, Uzun, O, Dickinson, DF, Parsons, JM, Chatrath, RR. Laser valvotomy with balloon valvoplasty for pulmonary atresia with intact ventricular septum: five years’ experience. Heart 1997; 77: 225228.CrossRefGoogle ScholarPubMed

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 6
Total number of PDF views: 84 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 21st April 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Pulmonary atresia with intact septum: the use of Conquest Pro coronary guidewire for perforation of atretic valve and subsequent interventions
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *