Téma: 

Diagnosis and interventional treatment of isolated valvular pulmonic stenosis

Ján Zelenay, Viliam Fridrich

Aim: The aim of the treatment of isolated valvular pulmonic stenosis is to remove or reduce severe stenosis of the pulmonic valve without using surgical intervention. Patients and methods: Our retrospective study involved 25 patients of average age of 42.5 years (mean age 42.5 years). In 16 women (64 %) and 9 men (36 %) anatomical, morphological, haemodynamics and functioal success of percutaneous translumonal pulmonal valvuloplasty (PTPV) was evaluated. Narrowing of the pulmonal valve with peak systolic gradient (PSG) the right ventricle-pulmonal artery over 50 mmHg with the index of systolic intraventricular pressures over 0.5 and the index of the pulmonal valve surface less than 0.79 cm2/m2, were considered significant. Before PTPV the whole set of patients was classified (according to functional classification NYHA) as NYHA 3.3. Result: Before PTPV the average PSG was 106.5 mmHg. After PTPV PSG was reduced to 38.4 mmHg (p < 0.001). The average ISVKT before intervention was 1.12, after intervention 0.44 (p < 0.0001). The average IPPCH was 0.44 cm2/m2. After PTPV an increase to 0.82 cm2/m2. In long term follow-up 84 % of patients benefit from the treatment (average functional classification NYHA 2.0) Conclusion: Percutaneous transluminal pulmonal valvuloplasty is, in the treatment of isolated valvular pulmonic stenosis, the method of the first and most definite choice for very good therapeutic results, lower costs and lower invasiveness.

Ročník 2006  Témy časopisu Cardiology for practice 2 / 2006

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MEMBERS OF THE EDITORIAL BOARD
MUDr. Peter Dědič
MUDr. Juraj Dúbrava, PhD., FESC
MUDr. Viliam Fridrich, PhD.
doc. MUDr. Ján Kmec, PhD.
MUDr. Gabriela Kaliská, PhD., FESC
MUDr. Pavol Lesný
MUDr. Monika Kaldarárová, PhD.
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prof. MUDr. Daniel Pella, PhD.
prof. MUDr. Iveta Šimková, CSc., FESC
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MUDr. Juraj Dúbrava, PhD., FESC

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Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett´ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285: 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

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In which patients, after overcoming of a thromboembolic cerebral or peripheral event, the least suitable catheter closure is foramen ovale patents:
a. a woman before planned pregnancy
b. paroxysmal fibrillation of the atrium
c. aneurysm of the atrium septum
d. origination of an event after cough

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