Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum

IntroductionPercutaneous balloon valvuloplasty is the treatment of choice for critical pulmonary valve stenosis (CPS) and pulmonary valve atresia with intact ventricular septum (PA/IVS) if the ventricle has a suitable size. This study aimed to evaluate the long-term outcomes and predictors for surgi...

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Main Authors: Tariq Abu-Tair, Ines Willershausen, Melanie Friedmann, Kai Rubarth, Annika Weigelt, Claudia Martin, Sven Dittrich, Christoph Kampmann
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1527832/full
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author Tariq Abu-Tair
Tariq Abu-Tair
Ines Willershausen
Melanie Friedmann
Kai Rubarth
Annika Weigelt
Claudia Martin
Sven Dittrich
Christoph Kampmann
author_facet Tariq Abu-Tair
Tariq Abu-Tair
Ines Willershausen
Melanie Friedmann
Kai Rubarth
Annika Weigelt
Claudia Martin
Sven Dittrich
Christoph Kampmann
author_sort Tariq Abu-Tair
collection DOAJ
description IntroductionPercutaneous balloon valvuloplasty is the treatment of choice for critical pulmonary valve stenosis (CPS) and pulmonary valve atresia with intact ventricular septum (PA/IVS) if the ventricle has a suitable size. This study aimed to evaluate the long-term outcomes and predictors for surgical intervention and pulmonary valve replacement in patients with CPS or with PA/IVS after PBV, considering different morphological and hemodynamic parameters.MethodsNeonates with PA/IVS or CPS who were admitted to the University Medicine Mainz and University Hospital Erlangen between November 1994 and March 2013 and underwent successful PBV as an initial procedure, with a follow-up of at least 5 years (median 13.1 years), were included. The Z-scores of pulmonary valve diameter, balloon/annulus ratio, number of cusps, and persisting stenosis were analyzed. The endpoint was the need for surgical procedures or valve replacement.ResultsA total of 62 neonates (median age at intervention 5 days) were included. Among them, 15 patients (24.2%) reached the endpoint. The mean time of freedom from surgery differed according to the number of cusps (P < 0.001), pulmonary valve diameter Z-scores (P = 0.04), and degree of persisting stenosis (P = 0.008), but did not differ according to the balloon/annulus ratio (≤1.2 vs. >1.2).ConclusionPulmonary valve perforation and PBV achieved favorable long-term outcomes in neonates with PA/IVS and CPS. A small pulmonary valve diameter, reduced number of cusps, and persisting gradient of >40 mmHg increased the risk for reduced time of freedom from surgical intervention and/or pulmonary valve replacement.
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spelling doaj-art-011caabebff8471ba9b007a40bc017132025-08-20T02:06:16ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-03-011210.3389/fcvm.2025.15278321527832Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septumTariq Abu-Tair0Tariq Abu-Tair1Ines Willershausen2Melanie Friedmann3Kai Rubarth4Annika Weigelt5Claudia Martin6Sven Dittrich7Christoph Kampmann8Department of Congenital Heart Diseases, Centre for Diseases in Childhood and Adolescence, University Medicine Mainz, Mainz, GermanyDepartment of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, GermanyDepartment of Orthodontics and Orofacial Orthopedics, Friedrich Alexander-University Erlangen-Nürnberg, Erlangen, GermanyDepartment of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, GermanyDepartment of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, GermanyDepartment of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, GermanyDepartment of Congenital Heart Diseases, Centre for Diseases in Childhood and Adolescence, University Medicine Mainz, Mainz, GermanyDepartment of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, GermanyDepartment of Congenital Heart Diseases, Centre for Diseases in Childhood and Adolescence, University Medicine Mainz, Mainz, GermanyIntroductionPercutaneous balloon valvuloplasty is the treatment of choice for critical pulmonary valve stenosis (CPS) and pulmonary valve atresia with intact ventricular septum (PA/IVS) if the ventricle has a suitable size. This study aimed to evaluate the long-term outcomes and predictors for surgical intervention and pulmonary valve replacement in patients with CPS or with PA/IVS after PBV, considering different morphological and hemodynamic parameters.MethodsNeonates with PA/IVS or CPS who were admitted to the University Medicine Mainz and University Hospital Erlangen between November 1994 and March 2013 and underwent successful PBV as an initial procedure, with a follow-up of at least 5 years (median 13.1 years), were included. The Z-scores of pulmonary valve diameter, balloon/annulus ratio, number of cusps, and persisting stenosis were analyzed. The endpoint was the need for surgical procedures or valve replacement.ResultsA total of 62 neonates (median age at intervention 5 days) were included. Among them, 15 patients (24.2%) reached the endpoint. The mean time of freedom from surgery differed according to the number of cusps (P < 0.001), pulmonary valve diameter Z-scores (P = 0.04), and degree of persisting stenosis (P = 0.008), but did not differ according to the balloon/annulus ratio (≤1.2 vs. >1.2).ConclusionPulmonary valve perforation and PBV achieved favorable long-term outcomes in neonates with PA/IVS and CPS. A small pulmonary valve diameter, reduced number of cusps, and persisting gradient of >40 mmHg increased the risk for reduced time of freedom from surgical intervention and/or pulmonary valve replacement.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1527832/fulloutcomeballoon valvuloplastypulmonary valvepulmonary atresiapulmonary stenosis
spellingShingle Tariq Abu-Tair
Tariq Abu-Tair
Ines Willershausen
Melanie Friedmann
Kai Rubarth
Annika Weigelt
Claudia Martin
Sven Dittrich
Christoph Kampmann
Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum
Frontiers in Cardiovascular Medicine
outcome
balloon valvuloplasty
pulmonary valve
pulmonary atresia
pulmonary stenosis
title Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum
title_full Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum
title_fullStr Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum
title_full_unstemmed Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum
title_short Predictors for long-term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum
title_sort predictors for long term outcome of pulmonary valve perforation and balloon valvuloplasty in neonates with critical pulmonary valve stenosis or pulmonary valve atresia with intact ventricular septum
topic outcome
balloon valvuloplasty
pulmonary valve
pulmonary atresia
pulmonary stenosis
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1527832/full
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