ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
An evaluation of efficacy and utility of palliative pulmonary balloon valvuloplasty in symptomatic infants with tetralogy of Fallot
İbrahim Halil Demir1, Ahmet Çelebi1, Türkay Sarıtaş1, Fadli Demir1, Nurdan Erol1, İlker Kemal Yücel1, Reyhan Dedeoğlu1, Numan Ali Aydemir2, Abdullah Erdem1
1Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Pediyatrik Kardiyoloji Kliniği, İstanbul, Türkiye
2Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2013.7724
Background: In this study, we aimed to evaluate the results, efficacy and utility of palliative pulmonary balloon valvuloplasty (PPBV) procedure performed on tetralogy of Fallot (TOF) patients.

Methods: Study population included 40 TOF patients aged under one year who underwent PPBV between July 2005 and November 2011. The indications for PPBV were defined as a pulse oxymetric oxygen saturation of <70% or echocardiographic McGoon index <1.7.

Results: The mean oxygen saturation increased from 66.1% to 83.5% following the procedure, which was statistically significant (p<0.0001). After PPBV, 13 patients had total repair directly without any other procedure. Five patients underwent a Blalock- Taussig (BT) shunt operation, while one had a Brock operation. During follow-up, 19 patients had a second cardiac catheterization. Patients who had a second cardiac catheterization had a statistically significant difference in terms of the McGoon index, the pulmonary annulus diameters and Z-scores, the right pulmonary artery diameters and Z-scores and the left pulmonary artery diameters and Z-scores. After the second cardiac catheterization, 17 more patients underwent total repair surgery. A total of 30 patients were able to undergo total repair surgery without any additional palliative method (transcatheter or surgical). The median time to delayed total repair was 12.5 months (range: 2-25 months). No procedure-related mortality was observed.

Conclusion: The PPBV is an effective, beneficial and safe procedure in TOF patients eliminating hypoxia, maintaining pulmonary vascular bed and delaying the surgery time for total repair.

Keywords : Balloon valvuloplasty; palliative; tetralogy of Fallot
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