Drighil Abdenasser, Aljufan Mansour, Slimi Amal, Yamani Samira, Mathewson James, AlFadly Fadl
Department of Cardiology, Ibn Rochd University Hospital, Quartier des hopitaux, Casablanca, Morocco.
Eur J Echocardiogr. 2010 Mar;11(2):172-5. doi: 10.1093/ejechocard/jep193. Epub 2009 Dec 3.
Pulmonary atresia with intact ventricular septum (PA-IVS) is a complex congenital heart malformation with multitude therapeutic approaches. Recently, balloon valvotomy has been used as an alternative to primary surgery. This study aimed to identify echocardiographic markers of balloon dilation success in PA-IVS.
The echocardiograms of 26 patients diagnosed with PA-IVS who underwent primary pulmonary balloon valvotomy were reviewed. Tricuspid annulus Z-score, pulmonary annulus Z-score, right ventricular (RV) to left ventricular (LV) length ratio, RV to LV transverse diameter ratio, and tricuspid valve (TV) to mitral valve (MV) annulus diameter ratio were measured. The tricuspid Z-score, pulmonary Z-score, RV/LV length ratio, RV/LV diameter ratio, and the TV/MV ratio were significantly different in the group which had successful balloon dilation compared with that failed. Based on decision trees using the Weka classifier package, only RV/LV diameter ratio >0.76 predicts a 92.3% success rate. In contrast, an RV/LV diameter ratio < or =0.76 associated with RV/LV length ratio < or =0.70 predicts 100% failure.
Successful balloon dilation in membranous type PA-IVS can be predicted by a scoring system using RV/LV diameter ratio and RV/LV length ratio.
室间隔完整的肺动脉闭锁（PA-IVS）是一种复杂的先天性心脏畸形，有多种治疗方法。最近，球囊瓣膜切开术已被用作初次手术的替代方法。本研究旨在确定PA-IVS中球囊扩张成功的超声心动图标志物。
回顾了26例诊断为PA-IVS并接受初次肺动脉球囊瓣膜切开术患者的超声心动图。测量三尖瓣环Z值、肺动脉环Z值、右心室（RV）与左心室（LV）长度比、RV与LV横径比以及三尖瓣（TV）与二尖瓣（MV）环直径比。与失败组相比，球囊扩张成功组的三尖瓣Z值、肺动脉Z值、RV/LV长度比、RV/LV直径比以及TV/MV比有显著差异。基于使用Weka分类器软件包的决策树，只有RV/LV直径比>0.76预测成功率为92.3%。相反，RV/LV直径比≤0.76且RV/LV长度比≤0.70则预测100%失败。
使用RV/LV直径比和RV/LV长度比的评分系统可预测膜性PA-IVS球囊扩张是否成功。
