Effects of Balloon Valvuloplasty on Coronary Blood Flow in Neonates With Critical Pulmonary Valve Stenosis Assessed With Transthoracic Doppler Echocardiography

published online 22 December 2008.

Background

Treating pulmonary valve stenosis with balloon valvuloplasty (BV) is a good model to study the effect of right ventricular (RV) pressures on coronary flow.

Methods

Transthoracic Doppler echocardiography was used to register coronary flow in 10 age-matched healthy controls and 7 neonates before and 1 day after BV.

Results

Left ventricular fractional shortening and cardiac output increased significantly after BV. Right coronary artery diameter decreased from 1.2 ± 0.2 to 1.1 ± 0.1 mm (P < .02). Posterior descending coronary artery flow parameters decreased significantly, with blood flow decreasing from 8.4 to 5.7 ± 1.9 mL/s (P < .003). RV end-diastolic pressure and RV systolic pressure explained almost totally the variation in coronary flow (r2 = 0.87).

Conclusions

RV end-diastolic pressure and RV systolic pressure determined coronary flow in neonates with critical pulmonary valve stenosis. Cardiac output and left ventricular fractional shortening increased after pulmonary valve BV.

Keywords: Coronary flow, Pulmonary valve stenosis, Transthoracic Doppler echocardiography

a Department of Pediatrics, Division of Pediatric Cardiology, Lund University Hospital, Lund, Sweden

b Institute of Clinical Medicine, Section for Pediatrics, University of Bergen, Bergen, Norway

Reprint requests: Elhadi H. Aburawi, MD, PhD, FRCPCH, Lund University Hospital, Getingevägen, SE-221 85, Lund, Sweden

This study was supported financially by Lund University Hospital and the Faculty of Medicine of Lund University, Lund, Sweden.

PII: S0894-7317(08)00657-3

doi:10.1016/j.echo.2008.10.021

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