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Combined Semilunar Valve Stenoses in Neonates: Management Approaches and Literature Review

Elhoury, Motea E.; El-Segaier, Milad LU ; Momenah, Tarek and Galal, Mohammed Omar (2014) In Pediatric Cardiology 35(8). p.1469-1473
Abstract
Combination of right and left ventricular outflow tracts obstruction is extremely rare. Neonates with combined aortic stenosis (AS) and pulmonary stenosis (PS) present in critical condition and required urgent treatment. The management approach is not well defined. We report five female neonates with combined AS and PS presented to our institute in the last 5 years, age (1-18 days), weight (2.2-3.4 kg). Two had associated muscular ventricular septal defects. The mean Doppler gradient across the aortic valve (AV) was 73 mmHg (53-105 mmHg) and across the pulmonary valve was 62 mmHg (44-76 mmHg). Three had balloon dilatation and one surgical repair. The fifth patient was managed conservatively, but had sudden cardiac death at age of 3 months.... (More)
Combination of right and left ventricular outflow tracts obstruction is extremely rare. Neonates with combined aortic stenosis (AS) and pulmonary stenosis (PS) present in critical condition and required urgent treatment. The management approach is not well defined. We report five female neonates with combined AS and PS presented to our institute in the last 5 years, age (1-18 days), weight (2.2-3.4 kg). Two had associated muscular ventricular septal defects. The mean Doppler gradient across the aortic valve (AV) was 73 mmHg (53-105 mmHg) and across the pulmonary valve was 62 mmHg (44-76 mmHg). Three had balloon dilatation and one surgical repair. The fifth patient was managed conservatively, but had sudden cardiac death at age of 3 months. One patient arrived in shock and sepsis, underwent emergency balloon dilation of the AV in the ICU. Despite decreasing the gradient, she died next day after the procedure. The surviving children were well at median follow-up age of 3.4 years. This is an extremely rare combination which needs early intervention. The management approach is not well defined. Interventional catheterization is possibly the better option. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Pulmonary valve stenosis, Aortic valve stenosis, Balloon valvuloplasty
in
Pediatric Cardiology
volume
35
issue
8
pages
1469 - 1473
publisher
Springer
external identifiers
  • wos:000345333100023
  • scopus:84939894533
ISSN
0172-0643
DOI
10.1007/s00246-014-1000-9
language
English
LU publication?
yes
id
c3ad25d2-4d9c-47af-a0c5-eb1ac4bfb416 (old id 4982951)
date added to LUP
2015-02-03 07:12:47
date last changed
2017-01-01 03:05:23
@article{c3ad25d2-4d9c-47af-a0c5-eb1ac4bfb416,
  abstract     = {Combination of right and left ventricular outflow tracts obstruction is extremely rare. Neonates with combined aortic stenosis (AS) and pulmonary stenosis (PS) present in critical condition and required urgent treatment. The management approach is not well defined. We report five female neonates with combined AS and PS presented to our institute in the last 5 years, age (1-18 days), weight (2.2-3.4 kg). Two had associated muscular ventricular septal defects. The mean Doppler gradient across the aortic valve (AV) was 73 mmHg (53-105 mmHg) and across the pulmonary valve was 62 mmHg (44-76 mmHg). Three had balloon dilatation and one surgical repair. The fifth patient was managed conservatively, but had sudden cardiac death at age of 3 months. One patient arrived in shock and sepsis, underwent emergency balloon dilation of the AV in the ICU. Despite decreasing the gradient, she died next day after the procedure. The surviving children were well at median follow-up age of 3.4 years. This is an extremely rare combination which needs early intervention. The management approach is not well defined. Interventional catheterization is possibly the better option.},
  author       = {Elhoury, Motea E. and El-Segaier, Milad and Momenah, Tarek and Galal, Mohammed Omar},
  issn         = {0172-0643},
  keyword      = {Pulmonary valve stenosis,Aortic valve stenosis,Balloon valvuloplasty},
  language     = {eng},
  number       = {8},
  pages        = {1469--1473},
  publisher    = {Springer},
  series       = {Pediatric Cardiology},
  title        = {Combined Semilunar Valve Stenoses in Neonates: Management Approaches and Literature Review},
  url          = {http://dx.doi.org/10.1007/s00246-014-1000-9},
  volume       = {35},
  year         = {2014},
}