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Variability of the diameter of the pulmonary outflow tract and its relation to balloon valvoplasty for congenital pulmonary valvar stenosis

Published online by Cambridge University Press:  19 August 2008

Roxy N. S. Lo ,
Maurice P. Leung ,
T. C. Yung  and
C. H. Chan
Roxy N. S. Lo*
Affiliation:
From the Department of Paediatrics, University of Hong Kong, Grantham Hospital, Hong Kong
Maurice P. Leung
Affiliation:
From the Department of Paediatrics, University of Hong Kong, Grantham Hospital, Hong Kong
T. C. Yung
Affiliation:
From the Department of Paediatrics, University of Hong Kong, Grantham Hospital, Hong Kong
C. H. Chan
Affiliation:
From the Department of Paediatrics, University of Hong Kong, Grantham Hospital, Hong Kong
*
Correspondence to Dr. Roxy N. S. Lo, Department of Pediatrics, University of Hong Kong, Grantham Hospital, 125 Wong Chuk Hang Road, Hong Kong.
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Summary

The diameter of the pulmonary outflow tract was measured from the right ventricular cineangiogram at different phases of the cardiac cycle prior to balloon valvoplasty in 54 patients with congenital pulmonary valvar stenosis. Measured at the level of the hinge point of the valvar leaflets, the pulmonary outflow tract was found to be largest at end-diastole and smallest at end-systole. The mean increase in diameter from systole to diastole was 25.3% (range 6–53%) for 47 patients with typical valvar stenosis, and 24.3% (range 14–41%) for seven patients with dysplastic valvar leaflets (p>0.5). Dilatation using balloons less than 1.2 times the size of the maximal end-diastolic diameter produced a mean reduction in the pressure gradient from right ventricle to pulmonary trunk of 71.1%, compared to 76.2% with bigger balloons (p>0.3). Two patients with an initial ratio between balloon and outflow tract of 0.9 required a second dilatation. The timing of measurement of the diameter of the pulmonary outflow tract should be standardized. Oversized balloons probably are not necessary for pulmonary valvoplasty.

Keywords

Balloon valvoplastypulmonary stenosisventriculo-pulmonary junctionthe valve “annulus”
Type
Original Articles
Information
Cardiology in the Young , Volume 3 , Issue 2 , April 1993 , pp. 111 - 117
Copyright
Copyright © Cambridge University Press 1993

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