Normal heart
Blood from the right ventricle goes through the pulmonary valve into the pulmonary arteries.
Pulmonary atresia with intact septum
Blood from the right ventricle cannot go through the pulmonary valve, it comes out to find a passage between the atria.
Dilatation of the pulmonary valve after perforation
A. Waisting of the balloon used to dilate the pulmonary valve marks.
B. Opening of the pulmonary valve with disappearance of the waist.
What is pulmonary atresia with intact ventricular septum?
Pulmonary atresia with intact ventricular septum (PA-IVS) is a rare congenital heart defect. In this condition, there is no passage between the right ventricle and the pulmonary artery. In other words, blood cannot flow normally to the lungs. The severity of this defect varies, but if the right ventricle is well developed, it becomes urgent at birth to open the pathway to the pulmonary arteries, in which case a puncture of the pulmonary valve is necessary.
Procedure for Neonatal Pulmonary Valve Perforation:
The perforation of the neonatal pulmonary valve is performed in the catheterization room. The newborn is placed under general anesthesia, lying on their back. The doctor performs a venous and arterial puncture in the groin area. From these access points, the doctor inserts thin catheters that are guided to the heart. The goal is to pass through the floor of the valve to position a balloon. The balloon is inflated to enlarge the valve and allow blood flow to the pulmonary arteries. At the end of the procedure, pressure is applied to the groin area for about ten minutes, and a compressive bandage is placed, which should be kept for a few hours.
On the left, the angiography shows the absence of opacification of the pulmonary arteries. On the right, after perforation, the passage of the contrast agent to the pulmonary arteries can be seen.
What are the risks of pulmonary valve perforation?
Once again, pulmonary valve perforation addresses a non-viable cardiac malformation in its current state. Pulmonary valve perforation remains a life-saving procedure.
What benefits can be expected from pulmonary valve perforation?
After a perforation of the pulmonary valve, the following days guide us towards the continuation of the treatment:
Either the lungs receive enough blood and the baby's growth is monitored without resorting to additional intervention.
Either the lungs do not receive enough blood and we are forced to perform additional percutaneous or surgical intervention.
Pulmonary atresia with intact septum
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