open access

Vol 25, No 2 (2018)
Original articles — Interventional cardiology
Published online: 2017-11-03
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Usefulness of cutting balloon angioplasty for the treatment of congenital heart defects

Jacek Kusa, Magdalena Mazurak, Agnieszka Skierska, Leslaw Szydlowski, Pawel Czesniewicz, Lukasz Manka
DOI: 10.5603/CJ.a2017.0128
·
Pubmed: 29131284
·
Cardiol J 2018;25(2):165-170.

open access

Vol 25, No 2 (2018)
Original articles — Interventional cardiology
Published online: 2017-11-03

Abstract

Background: Patients with complex congenital heart defects may have different hemodynamic prob­lems which require a variety of interventional procedures including angioplasty which involves using high-pressure balloons. After failure of conventional balloon angioplasty, cutting balloon angioplasty is the next treatment option available. The purpose of this study was to evaluate the safety and efficacy of cutting balloon angioplasty in children with different types of congenital heart defects.

Methods: Cutting balloon angioplasty was performed in 28 children with different congenital heart defects. The indication for cutting balloon angioplasty was: pulmonary artery stenosis in 17 patients, creating or dilatation of interatrial communication in 10 patients, and stenosis of left subclavian artery in 1 patient.

Results: In the pulmonary arteries group there was a significant decrease in systolic blood pressure (SBP) in the proximal part of the artery from the average 74.33 ± 20.4 mm Hg to 55 ± 16.7 mm Hg (p < 0.001). Distal to the stenosis there was an increase in SBP from 19.8 ± 3.82 mm Hg to 30.3 ± ± 13.3 mm Hg (p = 0.04). This result remained constant in the follow-up. In atrial septal defect/fenestra­tion group, cutting balloon angioplasty was performed after an unsuccessful classic Rashkind procedure. After cutting balloon angioplasty there was a significant widening of the interatrial communication.

Conclusions: Cutting balloon angioplasty is a feasible and effective treatment option in different con­genital heart defects.

Abstract

Background: Patients with complex congenital heart defects may have different hemodynamic prob­lems which require a variety of interventional procedures including angioplasty which involves using high-pressure balloons. After failure of conventional balloon angioplasty, cutting balloon angioplasty is the next treatment option available. The purpose of this study was to evaluate the safety and efficacy of cutting balloon angioplasty in children with different types of congenital heart defects.

Methods: Cutting balloon angioplasty was performed in 28 children with different congenital heart defects. The indication for cutting balloon angioplasty was: pulmonary artery stenosis in 17 patients, creating or dilatation of interatrial communication in 10 patients, and stenosis of left subclavian artery in 1 patient.

Results: In the pulmonary arteries group there was a significant decrease in systolic blood pressure (SBP) in the proximal part of the artery from the average 74.33 ± 20.4 mm Hg to 55 ± 16.7 mm Hg (p < 0.001). Distal to the stenosis there was an increase in SBP from 19.8 ± 3.82 mm Hg to 30.3 ± ± 13.3 mm Hg (p = 0.04). This result remained constant in the follow-up. In atrial septal defect/fenestra­tion group, cutting balloon angioplasty was performed after an unsuccessful classic Rashkind procedure. After cutting balloon angioplasty there was a significant widening of the interatrial communication.

Conclusions: Cutting balloon angioplasty is a feasible and effective treatment option in different con­genital heart defects.

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Keywords

cutting balloon, angioplasty, children, congenital heart defect

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About this article
Title

Usefulness of cutting balloon angioplasty for the treatment of congenital heart defects

Journal

Cardiology Journal

Issue

Vol 25, No 2 (2018)

Pages

165-170

Published online

2017-11-03

DOI

10.5603/CJ.a2017.0128

Pubmed

29131284

Bibliographic record

Cardiol J 2018;25(2):165-170.

Keywords

cutting balloon
angioplasty
children
congenital heart defect

Authors

Jacek Kusa
Magdalena Mazurak
Agnieszka Skierska
Leslaw Szydlowski
Pawel Czesniewicz
Lukasz Manka

References (8)
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  2. Cunningham JW, McElhinney DB, Gauvreau K, et al. Outcomes after primary transcatheter therapy in infants and young children with severe bilateral peripheral pulmonary artery stenosis. Circ Cardiovasc Interv. 2013; 6(4): 460–467.
  3. Rhodes JF, Lane GK, Mesia CI, et al. Cutting balloon angioplasty for children with small-vessel pulmonary artery stenoses. Catheter Cardiovasc Interv. 2002; 55(1): 73–77.
  4. Suda K, Matsumura M, Hayashi H, et al. Comparison of efficacy of medium-sized cutting balloons versus standard balloons for dilation of peripheral pulmonary stenosis. Am J Cardiol. 2006; 97(7): 1060–1063.
  5. Bergersen L, Gauvreau K, Justino H, et al. Randomized trial of cutting balloon compared with high-pressure angioplasty for the treatment of resistant pulmonary artery stenosis. Circulation. 2011; 124(22): 2388–2396.
  6. Butera G, Antonio LaT, Massimo C, et al. Expanding indications for the treatment of pulmonary artery stenosis in children by using cutting balloon angioplasty. Catheter Cardiovasc Interv. 2006; 67(3): 460–465.
  7. Ozawa A, Predescu D, Chaturvedi R, et al. Cutting balloon angioplasty for aortic coarctation. J Invasive Cardiol. 2009; 21(6): 295–299.
  8. Zussman M, Hirsch R, Beekman RH, et al. Impact of percutaneous interventions for pulmonary artery stenosis in alagille syndrome. Congenit Heart Dis. 2015; 10(4): 310–316.

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