Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults

Robin A Bertels; Michiel Dalinghaus; Maarten Witsenburg; Aagje Nijveld; Ad J J C Bogers; Folkert Meijboom; Anton van Oort; Ronald Tanke

doi:10.1017/S1047951112000157

Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults

Robin A Bertels, Michiel Dalinghaus, Maarten Witsenburg, Aagje Nijveld, Ad J J C Bogers, Folkert Meijboom, Anton van Oort, Ronald Tanke

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: To evaluate the results of balloon dilatation of stenotic homografts in children, adolescents, and young adults and to identify factors that might influence or predict the effect of the dilatation.

BACKGROUND: Homografts are widely used in congenital cardiac surgery; however, the longevity remains a problem mostly because of stenosis in the homograft. The effect of treatment by balloon dilatation is unclear.

METHODS: In a retrospective study, the effect of balloon dilatation was determined by the percentage of reduction of the peak systolic pressure gradient over the homograft during catheterisation and the postponement of re-intervention or replacement of the homograft in months. Successful dilatations - defined in this study as a reduction of more than 33% and postponement of more than 18 months - were compared with unsuccessful dilatations in search of factors influencing or predicting the results.

RESULTS: The mean reduction of the peak systolic pressure gradient was 30% in 40 procedures. Re-intervention or replacement of the homograft was postponed by a mean of 19 months. In all, 14 balloon dilatations (35%) were successful; the mean reduction was 49% and the mean postponement was 34 months. The time since homograft implantation, the presence of calcification, the homograft/balloon ratio, and the pressure applied during dilatation all tended to correlate with outcome, but were not statistically significant.

CONCLUSIONS: Balloon dilatation is able to reduce the peak systolic pressure gradient over homografts in a subgroup of patients and can be of clinical significance to postpone re-intervention or pulmonary valve replacement.

Original language	English
Pages (from-to)	589-95
Number of pages	7
Journal	Cardiology in the Young
Volume	22
Issue number	5
DOIs	https://doi.org/10.1017/S1047951112000157
Publication status	Published - 2012

Keywords

Adolescent
Adult
Aortic Valve Insufficiency
Aortic Valve Stenosis
Balloon Valvuloplasty
Child
Child, Preschool
Female
Follow-Up Studies
Heart Valve Prosthesis
Humans
Male
Prosthesis Failure
Pulmonary Valve
Retrospective Studies
Transplantation, Homologous
Young Adult

Access to Document

10.1017/S1047951112000157

Cite this

@article{34f946a5f6fa43948764c3385dfc6dcd,

title = "Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults",

abstract = "OBJECTIVES: To evaluate the results of balloon dilatation of stenotic homografts in children, adolescents, and young adults and to identify factors that might influence or predict the effect of the dilatation.BACKGROUND: Homografts are widely used in congenital cardiac surgery; however, the longevity remains a problem mostly because of stenosis in the homograft. The effect of treatment by balloon dilatation is unclear.METHODS: In a retrospective study, the effect of balloon dilatation was determined by the percentage of reduction of the peak systolic pressure gradient over the homograft during catheterisation and the postponement of re-intervention or replacement of the homograft in months. Successful dilatations - defined in this study as a reduction of more than 33% and postponement of more than 18 months - were compared with unsuccessful dilatations in search of factors influencing or predicting the results.RESULTS: The mean reduction of the peak systolic pressure gradient was 30% in 40 procedures. Re-intervention or replacement of the homograft was postponed by a mean of 19 months. In all, 14 balloon dilatations (35%) were successful; the mean reduction was 49% and the mean postponement was 34 months. The time since homograft implantation, the presence of calcification, the homograft/balloon ratio, and the pressure applied during dilatation all tended to correlate with outcome, but were not statistically significant.CONCLUSIONS: Balloon dilatation is able to reduce the peak systolic pressure gradient over homografts in a subgroup of patients and can be of clinical significance to postpone re-intervention or pulmonary valve replacement.",

keywords = "Adolescent, Adult, Aortic Valve Insufficiency, Aortic Valve Stenosis, Balloon Valvuloplasty, Child, Child, Preschool, Female, Follow-Up Studies, Heart Valve Prosthesis, Humans, Male, Prosthesis Failure, Pulmonary Valve, Retrospective Studies, Transplantation, Homologous, Young Adult",

author = "Bertels, {Robin A} and Michiel Dalinghaus and Maarten Witsenburg and Aagje Nijveld and Bogers, {Ad J J C} and Folkert Meijboom and {van Oort}, Anton and Ronald Tanke",

year = "2012",

doi = "10.1017/S1047951112000157",

language = "English",

volume = "22",

pages = "589--95",

journal = "Cardiology in the Young",

issn = "1047-9511",

publisher = "Cambridge University Press",

number = "5",

}

TY - JOUR

T1 - Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults

AU - Bertels, Robin A

AU - Dalinghaus, Michiel

AU - Witsenburg, Maarten

AU - Nijveld, Aagje

AU - Bogers, Ad J J C

AU - Meijboom, Folkert

AU - van Oort, Anton

AU - Tanke, Ronald

PY - 2012

Y1 - 2012

N2 - OBJECTIVES: To evaluate the results of balloon dilatation of stenotic homografts in children, adolescents, and young adults and to identify factors that might influence or predict the effect of the dilatation.BACKGROUND: Homografts are widely used in congenital cardiac surgery; however, the longevity remains a problem mostly because of stenosis in the homograft. The effect of treatment by balloon dilatation is unclear.METHODS: In a retrospective study, the effect of balloon dilatation was determined by the percentage of reduction of the peak systolic pressure gradient over the homograft during catheterisation and the postponement of re-intervention or replacement of the homograft in months. Successful dilatations - defined in this study as a reduction of more than 33% and postponement of more than 18 months - were compared with unsuccessful dilatations in search of factors influencing or predicting the results.RESULTS: The mean reduction of the peak systolic pressure gradient was 30% in 40 procedures. Re-intervention or replacement of the homograft was postponed by a mean of 19 months. In all, 14 balloon dilatations (35%) were successful; the mean reduction was 49% and the mean postponement was 34 months. The time since homograft implantation, the presence of calcification, the homograft/balloon ratio, and the pressure applied during dilatation all tended to correlate with outcome, but were not statistically significant.CONCLUSIONS: Balloon dilatation is able to reduce the peak systolic pressure gradient over homografts in a subgroup of patients and can be of clinical significance to postpone re-intervention or pulmonary valve replacement.

AB - OBJECTIVES: To evaluate the results of balloon dilatation of stenotic homografts in children, adolescents, and young adults and to identify factors that might influence or predict the effect of the dilatation.BACKGROUND: Homografts are widely used in congenital cardiac surgery; however, the longevity remains a problem mostly because of stenosis in the homograft. The effect of treatment by balloon dilatation is unclear.METHODS: In a retrospective study, the effect of balloon dilatation was determined by the percentage of reduction of the peak systolic pressure gradient over the homograft during catheterisation and the postponement of re-intervention or replacement of the homograft in months. Successful dilatations - defined in this study as a reduction of more than 33% and postponement of more than 18 months - were compared with unsuccessful dilatations in search of factors influencing or predicting the results.RESULTS: The mean reduction of the peak systolic pressure gradient was 30% in 40 procedures. Re-intervention or replacement of the homograft was postponed by a mean of 19 months. In all, 14 balloon dilatations (35%) were successful; the mean reduction was 49% and the mean postponement was 34 months. The time since homograft implantation, the presence of calcification, the homograft/balloon ratio, and the pressure applied during dilatation all tended to correlate with outcome, but were not statistically significant.CONCLUSIONS: Balloon dilatation is able to reduce the peak systolic pressure gradient over homografts in a subgroup of patients and can be of clinical significance to postpone re-intervention or pulmonary valve replacement.

KW - Adolescent

KW - Adult

KW - Aortic Valve Insufficiency

KW - Aortic Valve Stenosis

KW - Balloon Valvuloplasty

KW - Child

KW - Child, Preschool

KW - Female

KW - Follow-Up Studies

KW - Heart Valve Prosthesis

KW - Humans

KW - Male

KW - Prosthesis Failure

KW - Pulmonary Valve

KW - Retrospective Studies

KW - Transplantation, Homologous

KW - Young Adult

U2 - 10.1017/S1047951112000157

DO - 10.1017/S1047951112000157

M3 - Article

C2 - 22398105

SN - 1047-9511

VL - 22

SP - 589

EP - 595

JO - Cardiology in the Young

JF - Cardiology in the Young

IS - 5

ER -

Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults

Abstract

Keywords

Access to Document

Fingerprint

Cite this