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Use of triple ultra-high-pressure balloons for obstructed right ventricular outflow conduits in adults can be safe and effective

Published online by Cambridge University Press:  06 June 2014

Kazuto Fujimoto*
Department of Pediatrics, National Cerebral and Cardiovascular Center, Osaka, Japan
Hisashi Sugiyama
Department of Pediatrics, National Cerebral and Cardiovascular Center, Osaka, Japan
Satoshi Yazaki
Department of Pediatrics, National Cerebral and Cardiovascular Center, Osaka, Japan
Correspondence to: K. Fujimoto, Cardiovascular Center, Showa University, Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama city, Kanagawa 224-8503, Japan. Tel: +81 45 949 7000; Fax: +81-45-949-7117; E-mail:


To date, no transcatheter valve has been approved for placement in the pulmonary position in Japan. Consequently, percutaneous balloon dilatation may be advised for stenotic right ventricular outflow lesions; however, technical difficulties persist, particularly in adults. We describe the acute haemodynamic changes and outcome of balloon dilatation of right ventricular outflow obstruction using triple ultra-high pressure balloons. This is the first report of such a technical development, which seems to be safe and effective. A total of three adult patients, aged 25, 29, and 37 years, with severe conduit obstruction were referred for balloon dilatation. A triple ultra-high-pressure balloon technique was used in the three patients after unsuccessful double-balloon dilatation, or for highly calcified lesions, which were expected to require ultra-high pressure for effective relief. Following balloon dilatation, the pressure gradient decreased from 24, 30, 65 to 3, 25, 30 mmHg, respectively. There were no procedural complications except slightly increased pulmonary regurgitation. Balloon dilatation using a triple ultra-high pressure balloon technique can be a safe and effective palliative procedure for conduit obstruction in adult patients.

Original Articles
© Cambridge University Press 2014 

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