Materials and Methods
Study Population
We presented a retrospective study of 228 PVS children who underwent
PBPV at the Cardiology Department of Children’s Hospital of Chongqing
Medical University from January 2004 to October 2019. All participants
in this study were diagnosed with isolated PVS using echocardiography.
PVS
patients accompanied by patent
foramen ovale (PFO), patent ductus arteriosus (PDA), atrial septal
defects (ASDs), or ventricular septal defects (VSDs)
without
hemodynamic
compromise were included. Patients with other complex congenital cardiac
defects including double-outlet right ventricle, transposition of the
great arteries, tetralogy of Fallot, and other heart diseases with
hemodynamic compromise were excluded. The study protocol was approved by
the Ethics Committee of Children’s Hospital of Chongqing Medical
University.
Definition
In this study, quantitative assessment of PVS severity was based mainly
on the transpulmonary pressure gradient[8].
Pulmonary stenosis severity was defined based on the 2006
ACC/AHA guidelines on the
management of valvular heart disease[9]. The
accompanying PR is graded as mild, moderate, or
severe[10].
Data collection
Patient and procedural data were retrospectively collected from the
electronic patient database at the Pediatric Cardiology Department of
Children’s Hospital of Chongqing Medical University from January 2004 to
October 2019. All patients completed the preoperative routine
examinations, including blood routine, biochemistry, coagulation time,
hepatic and renal function, arterial blood gas, 12-lead
electrocardiogram (ECG), chest radiography, abdominal ultrasound,
transthoracic echocardiography (TTE), cardiac catheterization, and
angiography.
Echocardiographic Data
Standard M-mode and two-dimensional echocardiographic views in addition
to color Doppler and continuous-wave Doppler were carried out to examine
the velocity flow and morphology of the pulmonary valve, peak PVS
gradient, right ventricular dimensions, regurgitation of tricuspid and
pulmonary valve in addition to its degree, and systolic and diastolic
functions of the left ventricular. Using the simplified Bernoulli
equation (△P = 4v2), the maximum peak instantaneous systolic pressure
gradient was estimated from the transpulmonary flow velocity curve.
Cardiac catheterization and
angiography
Venous access was usually achieved via the femoral vein and where the
pig tail or balloon floating catheter is inserted for right cardiac
catheterization. All procedures were performed with a single balloon.
The data acquired from initial PBPV cardiac catheterization and
postoperative reports included right ventricular (RV) systolic pressure,
pulmonary artery (PA) systolic pressure, RV-PA PSEG, and systemic
systolic blood pressure.