No CrossRef data available.
Article contents
A retrograde approach for transcatheter valvotomy procedure in infants with pulmonary atresia intact ventricular septum (PA-IVS): retrograde versus antegrade approach
Published online by Cambridge University Press: 28 June 2022
Abstract
Introduction:
This study evaluates the retrograde approach compared to the antegrade approach in infants with PA-IVS who underwent transcatheter pulmonary valvotomy procedure at National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
Material and method:
This is a single-centre retrospective study conducted from January 2017 to June 2019 consisting of infants undergoing transcatheter pulmonary valvotomy procedures from our centre.
Results:
Among 3733 records of cardiac catheter procedure in paediatric patients during the last 3 years, there were 12 subjects with PA-IVS, where five subjects were done by antegrade approach and seven by retrograde approach. The retrograde approach is shown to excel the antegrade approach in terms of procedural time by 58.64 minutes (CI 95 % 32.97–84.29, p = 0.008) and PA-RV crossing time by 27 minutes (CI 95 % 14.01–39.99, p = 0.02). There was no significant difference in contrast used (120.23 ± 25.77 versus 150.27 ± 39.26 ml/BSA, p = 0.518), and right ventricle to pulmonary artery systolic pressure gradient after valvotomy (39.571 ± 5.814 versus 53.52 ± 29.15, p = 0.329) between the retrograde and the antegrade approach.
Conclusion:
The retrograde approach offered shorter procedural time and comparably satisfying results than the antegrade approach. The shorter procedural time was preferred due to the shorter duration of general anaesthesia, which may decrease the risk of neurodevelopmental deficits in the patient.
Keywords
- Type
- Original Article
- Information
- Copyright
- © The Author(s), 2022. Published by Cambridge University Press
References
Chikkabyrappa, SM, Loomba, RS, Tretter, JT. Pulmonary atresia with an intact ventricular septum: preoperative physiology, imaging, and management. Semin Cardiothorac Vasc Anesth 2018 Sep; 22: 245–255.CrossRefGoogle ScholarPubMed
McClain, MR, Hokanson, JS, Grazel, R, et al. Critical congenital heart disease newborn screening implementation: lessons learned. Matern Child Health J 2017 Jun; 21: 1240–1249.CrossRefGoogle ScholarPubMed
Humpl, T, Söderberg, B, McCrindle, BW, et al. Percutaneous balloon valvotomy in pulmonary atresia with intact ventricular septum: impact on patient care. Circulation 2003 Aug 19; 108: 826–832.CrossRefGoogle Scholar
Alwi, M, Geetha, K, Bilkis, AA, et al. Pulmonary atresia with intact ventricular septum percutaneous radiofrequency-assisted valvotomy and balloon dilation versus surgical valvotomy and Blalock Taussig shunt [Internet]. J Am Coll Cardiol 2000; 35: 468–476.CrossRefGoogle ScholarPubMed
Pedra, CA, de Sousa, LN, Pedra, SR, et al. New percutaneous techniques for perforating the pulmonary valve in pulmonary atresia with intact ventricular septum. Arq Bras Cardiol 2001 Nov; 77: 471–486.CrossRefGoogle ScholarPubMed
Bakhru, S, Marathe, S, Saxena, M, et al. Transcatheter pulmonary valve perforation using chronic total occlusion wire in pulmonary atresia with intact ventricular septum. Ann Pediatr Cardiol 2017 Jan; 10: 5–10.Google ScholarPubMed
Latson, LA. Nonsurgical treatment of a neonate with pulmonary atresia and intact ventricular septum by transcatheter puncture and balloon dilation of the atretic valve membrane. Am J Cardiol 1991 Jul 15; 68: 277–279.CrossRefGoogle Scholar
Zilberman, MV, Khoury, PR, Kimball, RT. Two-dimensional echocardiographic valve measurements in healthy children: gender-specific differences. Pediatr Cardiol 2005 Jul; 26: 356–360.CrossRefGoogle ScholarPubMed
Alcibar, J, Cabrera, A, Peña, N, Baraldi, C, Arriola, J, Aramendi, J. Guided transcatheter valvulotomy in pulmonary atresia with intact ventricular septum. Rev Esp Cardiol. 2003; 56: 822–825.CrossRefGoogle ScholarPubMed
Wang, JK, Wu, MH, Chang, CI, Chen, YS, Lue, HC. Outcomes of transcatheter valvotomy in patients with pulmonary atresia and intact ventricular septum. Am J Cardiol 1999 Nov 1; 84: 1055–1060.CrossRefGoogle Scholar
Reed, GW, Hantz, S, Cunningham, R, et al. Operational efficiency and productivity improvement initiatives in a large cardiac catheterization laboratory. JACC Cardiovasc Interv 2018 Feb 26; 11: 329–338.CrossRefGoogle Scholar
Qureshi, SM, Pushparajah, K, Taylor, D. Anaesthesia for paediatric diagnostic and interventional cardiological procedures. Contin Educ Anaesth Crit Care Pain 2015 Feb 1; 15: 1–6.CrossRefGoogle Scholar
Lam, JE, Lin, EP, Alexy, R, Aronson, LA. Anesthesia and the pediatric cardiac catheterization suite: a review. Paediatr Anaesth 2015 Feb; 25: 127–134.CrossRefGoogle ScholarPubMed
Food and Drug Administration US. FDA Drug Safety Communication: FDA Approves Label Changes for Use of General Anesthetic and Sedation Drugs in Young Children. US Food Drug Adm Drug Saf Commun, 2017.Google Scholar
McCann, ME, de Graaff, JC, Dorris, L, et al. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial. Lancet 2019 Feb 16; 393: 664–677.CrossRefGoogle Scholar
Peterson, RE, Freire, G, Marino, CJ, Jureidini, SB. Transthoracic echocardiographic assessment of coronary flow in the diagnosis of right ventricular-dependent coronary circulation in pulmonary atresia with intact ventricular septum [Internet]. Pediatr Cardiol 2018; 39: 967–975. DOI 10.1007/s00246-018-1846-3.CrossRefGoogle ScholarPubMed