Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 East Chicago Avenue, Box 21, Chicago, IL, 60611, USA.
Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Pediatr Cardiol. 2022 Mar;43(3):665-673. doi: 10.1007/s00246-021-02771-2. Epub 2021 Nov 28.
Percutaneous balloon pulmonary valvuloplasty (PBPV) is the treatment of choice for isolated pulmonary valve stenosis. While this procedure is highly efficacious and has an excellent safety profile, as currently practiced, patients are obligatorily exposed to the secondary risks of ionizing radiation and contrast media. To mitigate these risks, we developed a protocol which utilized echo guidance for portions of the procedure which typically require fluoroscopy and/or angiography. Ten cases of echo-guided pulmonary valvuloplasty (EG-PBPV) for isolated pulmonary stenosis in children less than a year of age were compared to a historical cohort of nineteen standard cases using fluoroscopy/angiography alone, which demonstrated equivalent procedural outcomes and safety, while achieving a median reduction in radiation (total dose area product) and contrast load of 80% and 84%, respectively. Our early experience demonstrates that EG-PBPV in neonates and infants has results equivalent to standard valvuloplasty but with less radiation and contrast.
经皮球囊肺动脉瓣成形术（PBPV）是治疗单纯性肺动脉瓣狭窄的首选方法。虽然该手术疗效显著且安全性良好，但目前的实践中，患者不可避免地会面临电离辐射和造影剂的二次风险。为了降低这些风险，我们制定了一个方案，在该方案中，我们利用超声引导替代了原本需要透视和/或血管造影的部分手术。将 10 例小于 1 岁的单纯性肺动脉瓣狭窄的患儿行超声引导下肺动脉瓣成形术（EG-PBPV）与单纯行透视/血管造影的 19 例标准病例进行比较，结果显示两组在手术结果和安全性方面具有可比性，同时，辐射（剂量面积乘积）和造影剂负荷中位数分别降低了 80%和 84%。我们的早期经验表明，新生儿和婴儿的 EG-PBPV 与标准的瓣成形术结果相当，但辐射和造影剂的用量更少。
