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Erschienen in: Pediatric Cardiology 1/2017

11.11.2016 | Original Article

Outcomes of Radiofrequency Perforation for Pulmonary Atresia and Intact Ventricular Septum: A Single-Centre Experience

verfasst von: Steven Rathgeber, Benjamin Auld, Stephanie Duncombe, Martin C. K. Hosking, Kevin C. Harris

Erschienen in: Pediatric Cardiology | Ausgabe 1/2017

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Abstract

Percutaneous radiofrequency perforation (RFP) of the pulmonary valve is used as a primary therapy in neonates with pulmonary atresia and intact ventricular septum (PAIVS). We sought to determine the safety and efficacy of RFP for PAIVS in a single center and assess the pre-intervention anatomical parameters associated with a biventricular outcome. We retrospectively reviewed all cases of PAIVS treated with RFP at a single center from 1999 through 2012. We collected baseline imaging data, technical aspects of the procedure, adverse events and outcomes. RFP was attempted in 18 patients with 17 successful procedures. There was no mortality; one patient had an acute complication requiring surgical intervention. All were alive at the most recent follow-up (median 4.9 years; IQR = 2.0–6.8 years), 12/17 (71%) had a biventricular circulation, 2/17 (12%) had a 1½ ventricle repair, 2/17 (12%) had a univentricular repair and 1/17 was lost to follow-up. A biventricular outcome in patients with PAIVS was associated with the pre-intervention tricuspid valve/mitral valve (TV/MV) ratio and tricuspid valve (TV) z-score. The median TV/MV ratio for patients who underwent a biventricular repair and a non-biventricular repair was 0.82 (IQR = 0.71–0.90) and 0.59 (IQR = 0.39–0.76), P = 0.036, respectively. The median TV z-scores were −3.2 [(−4.9 to −2.6), and −6.8 (−9.7 to −4.8] P = 0.036 for the biventricular and non-biventricular groups, respectively. RFP is a safe primary therapy for PAIVS. With appropriate patient selection, RFP will often result in a biventricular circulation. Both the TV/MV and TV z-score were found to be a predictor of a biventricular outcome in our cohort.
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Metadaten
Titel
Outcomes of Radiofrequency Perforation for Pulmonary Atresia and Intact Ventricular Septum: A Single-Centre Experience
verfasst von
Steven Rathgeber
Benjamin Auld
Stephanie Duncombe
Martin C. K. Hosking
Kevin C. Harris
Publikationsdatum
11.11.2016
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 1/2017
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-016-1498-0

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