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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 ,
Rahmat R. Budi ,
Marhisham Che Mood ,
Ming C. Leong  and
Hasri Samion
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
*
Correspondence to: Dr M. Alwi, MRCP, Department of Paediatric Cardiology, National Heart Institute, 145 Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia. Tel: +603 261 78465; Fax: +60 3 26946478; E-mail: mazeni@ijn.com.my
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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.

Keywords

Neonatalinterventionvalvotomy
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 2 , April 2013 , pp. 197 - 202
Copyright
Copyright © Cambridge University Press 2012 

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