[The percutaneous transluminal balloon valvuloplasty of valvular stenosis of the pulmonary artery in treating tetralogy of Fallot as an alternative to the surgery of applying a systemic-pulmonary anastomosis].

From January 1991 to May 1992 transluminal balloon valvuloplasty [correction of vulvoplasty] of severe valvular stenosis of the pulmonary artery was performed in 14 patients with Fallot's tetrad at the Institute of Cardiovascular Surgery named after A. N. Bakulev. Five of them had pulmonary artery hypoplasia, 2 had stenosis and hypofunction of the systemic-pulmonary anastomosis applied by the Blalock-Taussig, which made them perform balloon angioplasty of the narrowed distal portion of the anastomosis. The patients' age ranged from 11 months to 14 years (mean age 6.8 +/- 1.1 years). Arterial blood oxygen saturation varied from 51 to 72% (mean 69.2 +/- 2.4%). The diameter of a valvular ring was 8-13 mm. The diameter of a balloon catheter exceeded that of the valvular ring by 20-25%. After dilation, arterial blood oxygen saturation increased from 69.86 +/- 2.5 to 85.1 +/- 1.2%. The angiometry performed after pulmonary artery valvuloplasty in patients with pulmonary hypoplasia showed an increase in sizes of all pulmonary arterial segments on an average by 22.5 +/- 4.1%. Later on 5 patients were radically operated on. Thus, with the ultimate goal of preparation of patients with severe Fallot's tetrad for radical surgery, transluminal balloon valvuloplasty in some patients with severe valvular stenosis of the pulmonary artery may be alternative to a systemic-pulmonary anastomosing operation.