Concurrent percutaneous atrial septal defect closure and pulmonary valvuloplasty

    DAI Zhengª²Xue, ZhANG Yuª²Shun, WANG Haiª²Chang, JIA Guoª²Liang, LIU Jianª²Ping, WANG Xiaoª²Yan

    Department of Cardiovasology, Xijing Hospital, Fourth Military Medical University, Xi¬ðan 710033, China

    ¡¾Abstract¡¿ AIM: To evaluate the effectiveness and short term results of combined percutaneous ballon pulmonary valvuloplasty (PBPV) and atrial septal defect closure for pulmonary valvular stenosis (PS) associated with seccundum atrial septal defect (ASD) . METHODS: Eight patients, 3~37 (13¡À15)years old, were confirmed with ASD in association with PS by transthoracic echocardiography (TTE). Percutaneous balloon pulmonary valvuloplasty (PBPV) was done initially; ASD was closed later using Amplatzer occluder device under guidance of fluoroscopy and transesophageal echocardiography (TEE)or TTE, TTE were performed immediately and 24 h, 1 mo, 3 mo and 6 mo after occlusion to evaluate the efficiency. RESULTS: The procedure was successful in all 8 patients. Right ventricular systolic pressure significantly decreased from (11.57¡À4.09) kPa to [5.49¡À2.09 kPa (P<0.001)]. The transpulmonary valve systolic gradient significantly decreased from (7.57¡À4.49) kPa to [1.89¡À1.63 kPa (P<0.001)] immediately after PBPV; No residual shunt of atrial septal was found in 8 patients immediately after the procedure and in the followª²up. CONCLUSION: Simultaneous PBPV and closure of the ASD appears to be an effective and safe modality for PS associated with ASD .It should be an alternative to surgery. ......