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Controlled transient respiratory arrest along with rapid right ventricular pacing for improving balloon stability during balloon valvuloplasty in pediatric patients with congenital aortic stenosis - A retrospective case series analysis


1 Department of Anaesthesiology, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India
2 School of Digestive and Liver Disease, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India
3 Department of Cardiology, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India

Correspondence Address:
Sampa Dutta Gupta
42 Lake Place, Kolkata - 700 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.69076

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Year : 2010  |  Volume : 13  |  Issue : 3  |  Page : 236-240

 

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Rapid right ventricular pacing is safe, effective, and established method to provide balloon stability during balloon aortic valvuloplasty (BAV). Controlled transient respiratory arrest at this point of time may further reduce left ventricular stroke volume, providing an additional benefit to maintain balloon stability. Two groups were studied. Among the 10 patients, five had rapid pacing alone (Group A), while the other five were provided with cessation of positive pressure breathing as well (Group B). The outcomes of BAV in the two groups of patients were studied. One patient in Group A had failed balloon dilatation even after the fourth attempt, while in Group B there were no failures. The peak systolic gradient reduction was higher in Group B (70.05% in comparison to 52.16% of group A). In Group A, five subjects developed aortic regurgitation (grade 2 in four and grade 3 in one, while no grade 3 aortic regurgitation developed in any patient in Group B). Controlled transient respiratory arrest along with rapid ventricular pacing may be effective in maintaining balloon stability and improve the outcome of BAV.






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1 Department of Anaesthesiology, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India
2 School of Digestive and Liver Disease, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India
3 Department of Cardiology, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, India

Correspondence Address:
Sampa Dutta Gupta
42 Lake Place, Kolkata - 700 029
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.69076

Rights and Permissions

Rapid right ventricular pacing is safe, effective, and established method to provide balloon stability during balloon aortic valvuloplasty (BAV). Controlled transient respiratory arrest at this point of time may further reduce left ventricular stroke volume, providing an additional benefit to maintain balloon stability. Two groups were studied. Among the 10 patients, five had rapid pacing alone (Group A), while the other five were provided with cessation of positive pressure breathing as well (Group B). The outcomes of BAV in the two groups of patients were studied. One patient in Group A had failed balloon dilatation even after the fourth attempt, while in Group B there were no failures. The peak systolic gradient reduction was higher in Group B (70.05% in comparison to 52.16% of group A). In Group A, five subjects developed aortic regurgitation (grade 2 in four and grade 3 in one, while no grade 3 aortic regurgitation developed in any patient in Group B). Controlled transient respiratory arrest along with rapid ventricular pacing may be effective in maintaining balloon stability and improve the outcome of BAV.






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