| Abstract: | Balloon valvuloplasty (BV) in neonates with critical pulmonary valve stenosis (CPVS) is limited by technical considerations, mainly the difficulty of traversing the stenotic valve. To simplify the procedure we used a 4F Cobra Type I catheter to cross the pulmonary valve (PV) without the aid of a guidewire, and performed single-stage BV, using low-profile balloons, in 12 neonates with CPVS. Procedure and total fluoroscopy times were 69 ± 33 min (42–125 min) and 34 ± 19 min (20–58 min), respectively. Following BV, right ventricular systolic pressure (RVSP) decreased from 102 ± 17 mm Hg to 56 ± 15 mm Hg (p < 0.001); and the ratio of RVSP to aortic systolic pressure decreased from 1.39 ± 0.22 to 0.73 ± 0.21 (p < 0.001). No significant complications were observed. BV failed in two patients, who subsequently had surgery. At follow-up (a mean of 19 months), Doppler gradient was 19 ± 12 mm Hg (0–50 mm Hg). BV was repeated in one patient. We conclude that in neonates with CPVS, the use of the 4F Cobra type I catheter facilitates crossing of the PV and allows performance of BV in a single stage; this enhances safety and time-efficiency, and shortens exposure to radiation. Cathet. Cardiovasc. Diagn. 40:322–325, 1997. © 1997 Wiley-Liss, Inc. |
