Moras Patrizio, Luciano Pasquini, Campanale Cosimo Marco, Masci Marco, Serena Ventrella, Luca Di Chiara, Gianfranco Butera, Toscano Alessandra
Perinatal Cardiology Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Department of Maternal-Fetal Medicine, Policlinico A. Gemelli IRCCS, Rome, Italy.
Echocardiography. 2025 May;42(5):e70182. doi: 10.1111/echo.70182.
Pulmonary valve balloon dilation (PVBD) has largely replaced surgical decompression as the preferred treatment for neonates with pulmonary atresia with intact ventricular septum (PAIVS) or critical pulmonary stenosis (CPS). This study aims to evaluate whether echocardiographic morphological and functional assessment can predict early complications and guide intensive care management following PVBD in this population.
We retrospectively analyzed 27 neonates with PAIVS or CPS who underwent PVBD between 2017 and 2023. Patients were divided into Group A (tripartite right ventricle [RV], developed infundibulum) and Group B (bipartite RV, hypoplastic infundibulum). Echocardiographic, catheterization, and clinical data were reviewed and compared.
Group A had higher rates of transient left ventricular systolic dysfunction (92.9% vs. 15.4%, p < 0.001) and required more ventilatory and inotropic support. Group B was more prone to infundibular spasm (76.9% vs. 21.4%, p = 0.004) and often needed beta-blockers or additional pulmonary blood flow.
Echocardiographic RV phenotype is associated with specific post-PVBD complications and may help guide early post-procedural management.
对于室间隔完整的肺动脉闭锁（PAIVS）或重度肺动脉狭窄（CPS）的新生儿，肺动脉瓣球囊扩张术（PVBD）已在很大程度上取代了外科减压术，成为首选治疗方法。本研究旨在评估超声心动图形态学和功能评估能否预测该人群PVBD术后的早期并发症并指导重症监护管理。
我们回顾性分析了2017年至2023年间接受PVBD的27例PAIVS或CPS新生儿。患者分为A组（三部分右心室[RV]，漏斗部发育良好）和B组（两部分RV，漏斗部发育不良）。对超声心动图、心导管检查和临床数据进行了回顾和比较。
A组短暂性左心室收缩功能障碍的发生率更高（92.9%对15.4%，p<0.001），需要更多的通气和正性肌力支持。B组更容易发生漏斗部痉挛（76.9%对21.4%，p = 0.004），且经常需要使用β受体阻滞剂或增加肺血流量。
超声心动图显示的RV表型与PVBD术后特定并发症相关，可能有助于指导术后早期管理。
