Department of Cardiac Surgery, Fujian Medical University Union Hospital, Fujian, China.
Heart Surg Forum. 2021 Feb 19;24(1):E185-E187. doi: 10.1532/hsf.3423.
Percutaneous balloon pulmonary valvuloplasty has proven to be a standard of care for neonates with severe pulmonary valve disease. However, the peripheral vessel injury, tricuspid chordae tendineae rupture, and cardiac tamponade could occur. Recently, we performed balloon valvuloplasty through pulmonary artery trunk. To date, the obtained outcome was promising.
Between January 2018 and December 2018, three neonates with critical pulmonary stenosis and two with membranous pulmonary atresia with intact ventricular septum were enrolled in our center. Balloon valvuloplasty through pulmonary artery trunk was performed in all patients. A 2-cm parasternal incision was made in the left third intercostal space. A guidewire was used to advance or perforate the pulmonary valve from the pulmonary artery trunk into the right ventricle, followed by balloon dilation of the valve.
The procedure was successful in all patients. The oxygen saturation increased immediately after the balloon dilation, while the right ventricular systolic pressure and the gradient across the pulmonary valve decreased. No severe complications occurred.
Balloon valvuloplasty through the pulmonary artery trunk is a safe and feasible alternative procedure. Thus, it could serve as a supplementary choice for treating severe pulmonary valve disease.
经皮球囊肺动脉瓣成形术已被证明是治疗严重肺动脉瓣疾病新生儿的标准治疗方法。然而，可能会发生外周血管损伤、三尖瓣腱索断裂和心脏压塞。最近，我们通过肺动脉干进行了球囊瓣膜成形术。迄今为止，所获得的结果是有希望的。
2018 年 1 月至 2018 年 12 月期间，我们中心收治了 3 例严重肺动脉瓣狭窄和 2 例膜性肺动脉瓣闭锁伴完整室间隔的新生儿。所有患者均行肺动脉干球囊瓣膜成形术。在左第 3 肋间肋间隙做一个 2 厘米的胸骨旁切口。导丝从肺动脉干进入右心室，穿过肺动脉瓣，然后进行球囊扩张。
所有患者的手术均成功。球囊扩张后，氧饱和度立即升高，而右心室收缩压和肺动脉瓣跨瓣梯度降低。无严重并发症发生。
经肺动脉干行球囊瓣膜成形术是一种安全可行的替代方法。因此，它可以作为治疗严重肺动脉瓣疾病的补充选择。
