PALLIATIVE TREATMENT FOR TETRALOGY OF FALLOT WITH PERCUTANEOUS BALLOON DILATATION OF RIGHT-VENTRICULAR OUTFLOW TRACT

Percutaneous balloon pulmonary dilatation of the right ventricular tra ct was performed on 16 children with tetralogy of Fallot for palliativ e purposes after routine cardiac catheterization. Immediate improvemen t in aortic saturation from 73.4 +/- 6.8 to 84.0 +/- 4.8% (mean +/- SD = 10.6 +/- 2.7%, P < 0.001) and clinical symptoms were achieved in al l 16 cases. The pressures in the right ventricle, pulmonary artery, le ft ventricle and aorta showed no remarkable changes after percutaneous balloon dilatation. The diameters of the proximal end and at the firs t branching of the right and left pulmonary arteries, pulmonary arteri al index and the diameter of the descending aorta at the diaphragm inc reased significantly after balloon dilatation (p value 0.0004-0.006). One child suffered from repeated cyanotic spells in spite of the immed iate improvement of aortic saturation. She received a left side Blaloc k-Taussig shunt 2 months after the balloon dilatation. None of the chi ldren had a significant complication. Eight had follow-up cardiac cath eterization one year later and demonstrated much improvement in the di ameters of the proximal end and at the first branching of the right an d left pulmonary arteries, pulmonary arterial index and the diameter o f the descending aorta at the diaphragm (p value 0.005-0.04). AU 8 pat ients had their cardiac lesions successfully corrected. Percutaneous b alloon dilatation is an alternative palliative therapy for children wi th tetralogy of Fallot.