Abstract:

Objective To investigate the outcome of hybrid approaches of balloon valvuloplasty via pulmonary valve without cardiopulmonary bypass for pulmonary atresia with intact ventricular septum in neonates. Methods Eleven patients undergoing hybrid approaches of balloon valvuloplasty via pulmonary valve for pulmonary atresia with intact ventricular septum were selected, and the clinical features and surgical procedures were recorded. Results Among the 11 patients, there were 9 with pulmonary atresia with intact ventricular septum and 2 with severe pulmonary stenosis. The right ventricles were normally developed, and the Z values of tricuspid valves were >-2. All patients underwent balloon valvuloplasty via pulmonary valve without cardiopulmonary bypass, and there was no death during operation. The mean blood oxygen saturation after operation was (90±4)%, and there was no complication related to balloon valvuloplasty. Low cardiac output syndrome occurred in 2 patients, and there was no in-hospital death. Patients were followed up for an average of (8±3) months, all patients had mild to moderate pulmonary stenosis, and 1 needed a right ventricular outflow tract patch for pulmonary stenosis after operation. Conclusion Pulmonary valvuloplasty with hybrid technique is effective in management of pulmonary atresia with intact ventricular septum in neonates, which may provide adequate pulmonary blood flow and promote further growth of tricuspid valve and right ventricular cavity with less trauma and more safety.

Key words: hybrid approach, balloon dilation, pulmonary atresia with intact ventricular septum