Clinical efficacy analysis of percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis guided by ultrasound_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SUN Bao ¹ ,  CHENG Duan ¹ , LI Bo ² , HE Guibao ¹ , WANG Haifeng ¹ , Ahathi ¹ , Elias ¹ , SHENG Xi ¹ , LI Jinpeng ¹

1. Department of Cardiac Surgery, Xinjiang Cardiac and Neurovascular Disease Hospital, Urumqi, 830011, P.R.China;
2. Department of Ultrasound, Xinjiang Cardiac and Neurovascular Disease Hospital, Urumqi, 830011, P.R.China;

Corresponding?author：

CHENG Duan, Email: chengduan@126.com

Keywords：

Echocardiography; pulmonary valve stenosis; femoral vein; balloon dilatation

DOI：

10.7507/1007-4848.202002007

Video：

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Objective To analyze the efficacy and safety of percutaneous balloon pulmonary valvuloplasty (PBPV) for pulmonary valve stenosis guided by ultrasound.Methods From March 2016 to July 2019, 32 patients with pulmonary valve stenosis were treated in our hospital. There were 19 males and 13 females with an average age of 1-12 (6.2±3.1) years and weight of 7-45 (22.7±9.2) kg. The clinical efficacy of PBPV guided by transthoracic echocardiography (TTE) was evaluated.Results The transvalvular pressure gradient (PG) of the patients before PBPV was 65.4±11.9 mm Hg. All patients successfully received PBPV under TTE guidance. The PG was 19.7±4.0 mm Hg immediately after operation, which was significantly decreased (P<0.001). All patients survived without any serious complications. The PG values at 3 months, 6 months and 12 months after operation were 18.4±4.0 mm Hg, 16.4±3.9 mm Hg, 15.2±3.3 mm Hg, respectively, which were significantly lower than that before the operation (P<0.001).Conclusion PBPV guided by echocardiography is safe and effective in the treatment of pulmonary valve stenosis with low complications rate.

Citation： SUN Bao, CHENG Duan, LI Bo, HE Guibao, WANG Haifeng, Ahathi, Elias, SHENG Xi, LI Jinpeng. Clinical efficacy analysis of percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis guided by ultrasound. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(12): 1418-1422. doi: 10.7507/1007-4848.202002007 Copy

1.	Liu X, Liu G, Wang P, et al. Prevalence of congenital heart disease and its related risk indicators among 90,796 Chinese infants aged less than 6 months in Tianjin. Int J Epidemiol, 2015, 44(3): 884-893.
2.	Kan JS, White RI Jr, Mitchell SE, et al. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med, 1982, 307(9): 540-542.
3.	Deora S, Vyas C, Shah S, et al. Percutaneous balloon pulmonary valvuloplasty: a modified over-the-wire Inoue balloon technique for difficult right ventricular anatomy. Indian Heart J, 2014, 66(2): 211-213.
4.	Tefera E, Qureshi SA, Bermudez-Ca?ete R, et al. Percutaneous balloon dilation of severe pulmonary valve stenosis in patients with cyanosis and congestive heart failure. Catheter Cardiovasc Interv, 2014, 84(2): E7-E15.
5.	Devanagondi R, Peck D, Sagi J, et al. Long-term outcomes of balloon valvuloplasty for isolated pulmonary valve stenosis. Pediatr Cardiol, 2017, 38(2): 247-254.
6.	潘湘斌, 胡盛壽, 歐陽文斌, 等. 單純超聲引導下經皮肺動脈瓣球囊成形術的應用研究. 中華小兒外科雜志, 2015, 36(4): 286-288.
7.	Ou-Yang WB, Li SJ, Wang SZ, et al. Echocardiographic guided closure of perimembranous ventricular septal defects. Ann Thorac Surg, 2015, 100(4): 1398-1402.
8.	Schubert S, Kainz S, Peters B, et al. Interventional closure of atrial septal defects without fluoroscopy in adult and pediatric patients. Clin Res Cardiol, 2012, 101(9): 691-700.
9.	Massara M, Finocchiaro P, Volpe A, et al. Percutaneous drug-eluting balloon angioplasty to treat dialysis access stenosis. Semin Vasc Surg, 2017, 30(2-3): 67-69.
10.	楊博鑫, 李言, 武王將, 等. 心血管介入手術輻射劑量影響因素的分析. 北京生物醫學工程, 2019, 38(2): 171-176.
11.	王帆, 尹建東. 兒童介入治療輻射劑量影響因素及防護措施研究. 影像技術, 2019, 31(5): 29-31.
12.	國家衛生健康委員會國家心外介入質控專家組, 國家心血管病中心醫療質量控制中心心外介入專家組. 單純超聲心動圖引導經皮介入技術中國專家共識. 中國循環雜志, 2018, 33(10): 943-952.
13.	孫保, 程端, 李波, 等. 單純超聲引導下經股靜脈封堵篩孔型房間隔缺損的療效評價. 中國胸心血管外科臨床雜志, 2019, 26(9): 889-894.
14.	孫保, 程端, 李波, 等. 超聲引導下經皮逆行法封堵未閉動脈導管的有效性和安全性. 中國胸心血管外科臨床雜志, 2019, 26(12): 1208-1212.
15.	牟莉, 彭燕, 馬瓊英. 兒童胸部X線、CT 檢查的應用選擇. 中華肺部疾病雜志(電子版), 2018, 11(4): 479-480.
16.	楊貴明, 江榮, 趙勝, 等. 經皮球囊肺動脈瓣成形術治療兒童肺動脈瓣狹窄53例臨床分析. 安徽醫學, 2016, 37(6): 741-743.
17.	謝涌泉, 閆軍, 花中東, 等. 經胸與經皮肺動脈瓣球囊成形術治療肺動脈瓣狹窄的臨床對比研究. 中華外科雜志, 2017, 55(6): 459-462.
18.	Hong D, Qian MY, Zhang ZW, et al. Immediate therapeutic outcomes and medium-term follow-up of percutaneous balloon pulmonary valvuloplasty in infants with pulmonary valve stenosis: A single-center retrospective study. Chin Med J (Engl), 2017, 130(23): 2785-2792.
19.	Maostafa BA, Seyed-Hossien M, Shahrokh R. Long-term results of balloon pulmonary valvuloplasty in children with congenital pulmonary valve stenosis. Iran J Pediatr, 2013, 23(1): 32-36.
20.	Kim H, Sung SC, Choi KH, et al. Long-term results of pulmonary valve annular enlargement with valve repair in tetralogy of Fallot. Eur J Cardiothorac Surg, 2018, 53(6): 1223-1229.
21.	庹娟, 陳沅, 李謐, 等. 經皮球囊肺動脈瓣成形術治療兒童肺動脈瓣狹窄合并瓣下狹窄及瓣上狹窄的臨床分析. 重慶醫科大學學報, 2015, 40(4): 516-521.
22.	江勇, 歐陽文斌, 張麗, 等. 單純超聲引導兒童經皮肺動脈瓣狹窄球囊成形術的應用價值. 中華超聲影像學雜志, 2016, 23(6): 475-479.
23.	孫丹丹, 侯穎, 袁麗君, 等. 超聲多普勒方法估測肺動脈平均壓的效果比較. 中國超聲醫學雜志, 2016, 32(8): 714-716.
24.	岳國棟, 孫東艷, 董明華. 胎兒心臟超聲序列切面檢查在胎兒先天性心臟病診斷中的臨床價值分析. 中國婦幼保健, 2018, 33(14): 3333-3335.
25.	羅培, 李成, 王錦亮, 等. 超聲監測與心血管造影在小兒先天性心臟病介入治療中的指導作用. 中國醫藥, 2019, 14(11): 1632-1635.
26.	Wang SZ, Ou-Yang WB, Hu SS, et al. First-in-human percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance only. Congenit Heart Dis, 2016, 11(6): 716-720.

1. Liu X, Liu G, Wang P, et al. Prevalence of congenital heart disease and its related risk indicators among 90,796 Chinese infants aged less than 6 months in Tianjin. Int J Epidemiol, 2015, 44(3): 884-893.
2. Kan JS, White RI Jr, Mitchell SE, et al. Percutaneous balloon valvuloplasty: a new method for treating congenital pulmonary-valve stenosis. N Engl J Med, 1982, 307(9): 540-542.
3. Deora S, Vyas C, Shah S, et al. Percutaneous balloon pulmonary valvuloplasty: a modified over-the-wire Inoue balloon technique for difficult right ventricular anatomy. Indian Heart J, 2014, 66(2): 211-213.
4. Tefera E, Qureshi SA, Bermudez-Ca?ete R, et al. Percutaneous balloon dilation of severe pulmonary valve stenosis in patients with cyanosis and congestive heart failure. Catheter Cardiovasc Interv, 2014, 84(2): E7-E15.
5. Devanagondi R, Peck D, Sagi J, et al. Long-term outcomes of balloon valvuloplasty for isolated pulmonary valve stenosis. Pediatr Cardiol, 2017, 38(2): 247-254.
6. 潘湘斌, 胡盛壽, 歐陽文斌, 等. 單純超聲引導下經皮肺動脈瓣球囊成形術的應用研究. 中華小兒外科雜志, 2015, 36(4): 286-288.
7. Ou-Yang WB, Li SJ, Wang SZ, et al. Echocardiographic guided closure of perimembranous ventricular septal defects. Ann Thorac Surg, 2015, 100(4): 1398-1402.
8. Schubert S, Kainz S, Peters B, et al. Interventional closure of atrial septal defects without fluoroscopy in adult and pediatric patients. Clin Res Cardiol, 2012, 101(9): 691-700.
9. Massara M, Finocchiaro P, Volpe A, et al. Percutaneous drug-eluting balloon angioplasty to treat dialysis access stenosis. Semin Vasc Surg, 2017, 30(2-3): 67-69.
10. 楊博鑫, 李言, 武王將, 等. 心血管介入手術輻射劑量影響因素的分析. 北京生物醫學工程, 2019, 38(2): 171-176.
11. 王帆, 尹建東. 兒童介入治療輻射劑量影響因素及防護措施研究. 影像技術, 2019, 31(5): 29-31.
12. 國家衛生健康委員會國家心外介入質控專家組, 國家心血管病中心醫療質量控制中心心外介入專家組. 單純超聲心動圖引導經皮介入技術中國專家共識. 中國循環雜志, 2018, 33(10): 943-952.
13. 孫保, 程端, 李波, 等. 單純超聲引導下經股靜脈封堵篩孔型房間隔缺損的療效評價. 中國胸心血管外科臨床雜志, 2019, 26(9): 889-894.
14. 孫保, 程端, 李波, 等. 超聲引導下經皮逆行法封堵未閉動脈導管的有效性和安全性. 中國胸心血管外科臨床雜志, 2019, 26(12): 1208-1212.
15. 牟莉, 彭燕, 馬瓊英. 兒童胸部X線、CT 檢查的應用選擇. 中華肺部疾病雜志(電子版), 2018, 11(4): 479-480.
16. 楊貴明, 江榮, 趙勝, 等. 經皮球囊肺動脈瓣成形術治療兒童肺動脈瓣狹窄53例臨床分析. 安徽醫學, 2016, 37(6): 741-743.
17. 謝涌泉, 閆軍, 花中東, 等. 經胸與經皮肺動脈瓣球囊成形術治療肺動脈瓣狹窄的臨床對比研究. 中華外科雜志, 2017, 55(6): 459-462.
18. Hong D, Qian MY, Zhang ZW, et al. Immediate therapeutic outcomes and medium-term follow-up of percutaneous balloon pulmonary valvuloplasty in infants with pulmonary valve stenosis: A single-center retrospective study. Chin Med J (Engl), 2017, 130(23): 2785-2792.
19. Maostafa BA, Seyed-Hossien M, Shahrokh R. Long-term results of balloon pulmonary valvuloplasty in children with congenital pulmonary valve stenosis. Iran J Pediatr, 2013, 23(1): 32-36.
20. Kim H, Sung SC, Choi KH, et al. Long-term results of pulmonary valve annular enlargement with valve repair in tetralogy of Fallot. Eur J Cardiothorac Surg, 2018, 53(6): 1223-1229.
21. 庹娟, 陳沅, 李謐, 等. 經皮球囊肺動脈瓣成形術治療兒童肺動脈瓣狹窄合并瓣下狹窄及瓣上狹窄的臨床分析. 重慶醫科大學學報, 2015, 40(4): 516-521.
22. 江勇, 歐陽文斌, 張麗, 等. 單純超聲引導兒童經皮肺動脈瓣狹窄球囊成形術的應用價值. 中華超聲影像學雜志, 2016, 23(6): 475-479.
23. 孫丹丹, 侯穎, 袁麗君, 等. 超聲多普勒方法估測肺動脈平均壓的效果比較. 中國超聲醫學雜志, 2016, 32(8): 714-716.
24. 岳國棟, 孫東艷, 董明華. 胎兒心臟超聲序列切面檢查在胎兒先天性心臟病診斷中的臨床價值分析. 中國婦幼保健, 2018, 33(14): 3333-3335.
25. 羅培, 李成, 王錦亮, 等. 超聲監測與心血管造影在小兒先天性心臟病介入治療中的指導作用. 中國醫藥, 2019, 14(11): 1632-1635.
26. Wang SZ, Ou-Yang WB, Hu SS, et al. First-in-human percutaneous balloon pulmonary valvuloplasty under echocardiographic guidance only. Congenit Heart Dis, 2016, 11(6): 716-720.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical efficacy analysis of percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis guided by ultrasound

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