Isolated pulmonary valve selleck stenosis (PS) makes up 6-9% of all congenital heart defects among children. PS is divided into valvar, subvalvar, supravalvar, according to the anatomically stenotic portion, and valvar PS is known to be the most common type. The type of stenosis may be the deciding point for the method of therapy, surgical or interventional, and its effects.1) PS can be divided into mild,
moderate, and severe according to Inhibitors,research,lifescience,medical the pressure gradient between the systemic pressure and the right ventricle systolic pressure (RVSP): mild to moderate (RVSP ≤ 75% of systemic pressure); severe (RVSP 76-100% of systemic pressure); critical (RVSP > 100%). In the past, these patients were candidates Inhibitors,research,lifescience,medical of surgical valvotomy, but in moderate to severe PS, percutaneous balloon pulmonary valvuloplasty (BPV) has risen as the first treatment option since the first introduction in 1982.2) Since the initial adoption of the procedure, equipment for BPV has improved and the skills of the performers have selleck chem ameliorated, leading to minimal complications and its usefulness, proven in many previous studies.3-5)
The initial gold standard for diagnosis of PS is by echocardiography. In 2-dimensional (2D) echocardiography there can be evidence of right ventricle (RV) hypertrophy, RV enlargement, or right atrial enlargement. Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical Color flow Doppler imaging demonstrates high-velocity turbulent systolic flow through the pulmonary valve.6) Pressure gradients can simultaneously be estimated by continuous wave Doppler.7) Pressure gradients consist of echocardiographic systolic pressure gradient and mean pressure gradient. In case of aortic valve stenosis which is similar obstruction Inhibitors,research,lifescience,medical disease, mean pressure gradient is considered more important for evaluation of disease among those two gradients.8) However, the most accurate diagnosis still remains to be measurement of the pressure gradient through transcatheterization. The purpose of this study is to compare the difference between the echocardiographic data to
the cardiac catheterization data on the diagnosis, treatment, and follow-up in patients Brefeldin_A diagnosed as PS, and to see what parameters should be closely monitored. Methods Subjects A total of 112 patients (Male : Female = 46 : 66) who underwent BPV at Severance Cardiovascular Hospital, between December, 2002 to August, 2012 were retrospectively analyzed. The patients were all under 16 years of age and critical PS patients who underwent BPV were excluded from this study. The age range was between 1 month to 192 months and mean age 38.35 months (± 48.55 months). Patients with concomitant simple observable heart diseases such as atrial septal defect or patent foramen ovale were included, but those with complex heart diseases were excluded.