J Korean Pediatr Soc.  2003 Mar;46(3):250-258.

Medico-Surgical Cooperative Treatment of Pulmonary Atresia with Intact Ventricular Septum

• Kim KS
• Kweon BC
• Lee JK
• Choi JY
• Sul JH
• Lee SK
• Park YW
• Cho BK

Abstract

PURPOSE
The actual clinical examples of co-appliance of catheter intervention with surgical procedures in the treatment of pulmonary atresia with an intact ventricular septum(PA/IVS) which we have experienced in our institution are here shown, and the anatomical and hemodynamical profiles between each method is compared.
METHODS
Medical records of 33 patients with PA/IVS who underwent various treatment from January, 1995 to December, 2000 were reviewed for a retrograde study.
RESULTS
In three out of 10 patients who underwent percutaneous balloon pulmonary valvotomy (PPV), residual pulmonary stenosis were observed in their out patient department(OPD) follow-ups, eventually necessitatig balloon pulmonary valvuloplasty(BPV). One out of three patients exhibited deterioration of tricuspid regurgitation after BPV, requiring surgical tricuspid annuloplasty(TAP). Two out of the seven patients who received primarily surgical right ventricle outlet tract(RVOT) repair without any systemic-pulmonary shunt or intervention needed additional intervention employing cardiac catheterization after operation. Two patients received interventional catheterization before surgical RVOT repair. In five out of 11 cases of Fontan type operation, coil embolization of collateral circulation was done before total cavo-pulmonary connection(TCPC), and in three cases, interventional catheterization was needed after TCPC.
CONCLUSION
Both medical and surgical treatment modalities are widely used in management of PA/IVS patients, and recent results prove that medico-surgical cooperative treatment is essential.

Keyword

Percutaneous pulmonary balloon valvotomy(PPV); Surgical RVOT repair; Total cavo- pulmonary connection(TCPC); Right ventricle dependent coronary circulation(RVDCC); Balloon pulmonary valvuloplasty(BPV)

MeSH Terms

Cardiac Catheterization
Cardiac Catheters
Catheterization
Catheters
Collateral Circulation
Embolization, Therapeutic
Follow-Up Studies
Heart Ventricles
Humans
Medical Records
Pulmonary Atresia*
Pulmonary Valve Stenosis
Tricuspid Valve Insufficiency
Ventricular Septum*