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A perforation procedure for pulmonary atresia with intact ventricular septum: Egyptian experience and adaptations

机译：具有完整室间隔的肺部闭锁的穿孔程序：埃及经验和适应

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BackgroundPulmonary atresia with intact ventricular septum (PA-IVS) is an uncommon disorder with significant morphological heterogeneity. The use of percutaneous radiofrequency (RF)-assisted perforation of the atretic valve and subsequent balloon dilation provides arelatively easy but expensive procedure that is expected to establish ante-grade flow through the pulmonary valve in most patients.ObjectivesThe aim of the study was to attempt a cost reduction by using catheters and wires readily available in our catheter laboratory.MethodsAtotal of 50patients presenting with PA-IVS to Cairo University Children's Hospital (CUCH) were taken to the catheterization laboratory for radiofrequency perforation using the Baylis RFP-100 generator (Baylis Medical, Montreal, Canada) or the stiff end of a coronary wire. A hybrid approach was used in selected cases.ResultsThe overall success rate for valve perforation was 92% (46cases), 80% of which had successful primary perforation (40cases). Success correlated with both tricuspid valve (TV) annulus and pulmonary valve (PV) annulus Z-scores, with Pvalues of 0.2 and 0.5, respectively.ConclusionThe management of PA-IVS is complex. This is adisease that necessitates adedicated team and working collaboration between the cardiologists and cardiac surgeons. Cost limitation is essential in developing countries and innovative ideas to reduce costs are essential, especially if comparable success can be expected.
机译：BrucketionPulmonary Atresia具有完整室间隔（PA-IVS）是一种罕见的疾病，具有显着的形态异质性。使用经皮射频（RF）静置阀和随后的球囊扩张的穿孔提供了阶级性地简单但昂贵的程序，预计将建立通过大多数患者的肺瓣膜的抗腔流量。目的的目的是尝试通过在我们的导管实验室内使用导管和电线的成本减少。使用Baylis RFP-100发电机（Baylis Medical）（Baylis Medical ，蒙特利尔，加拿大）或冠状动脉的僵硬末端。在选定的情况下使用杂种方法。阀门穿孔的总成功率为92％（46例），其中80％具有成功的主要穿孔（40case）。成功与三尖瓣（TV）环和肺瓣膜（PV）环空Z分数相关，分别为0.2和0.5分别。结论PA-IVS的管理是复杂的。这是必要的，这需要在心脏病学家和心脏外科医生之间进行丰富的团队和工作合作。成本限制对于发展中国家至关重要，以降低成本的创新思想至关重要，特别是如果可以预期可比成功。

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