XXXX with intact ventricular septum percutaneous radiofrequency-assisted @entity384 versus surgical valvotomy and Blalock Taussig shunt.

@entity1 @entity384 @entity1146 @entity509
OBJECTIVE: We compared the result of radiofrequency (RF)-assisted @entity384 with closed surgical valvotomy and Blalock Taussig (BT) shunt as primary treatment in selected @entity1 with @entity1146 and intact ventricular septum (PA-IVS). BACKGROUND: @entity1 with PA-IVS who have mild to moderate @entity509 of the right ventricle (RV) and patent infundibulum have the greatest potential for complete biventricular circulation. The use of RF or laser wires to perforate the atretic valve followed by @entity384 provides an alternative to surgery. METHODS: Between May 1990 and March 1998, 33 selected @entity1 underwent either percutaneous @entity384 (group 1, n = 21; two crossed over to group 2) or surgical valvotomy with concomitant BT shunt (group 2, n = 14). Second RV decompression by @entity384 or right ventricular outflow tract (RVOT) reconstruction were performed if necessary. @entity1 who remained cyanosed were subjected to transcatheter trial closure of the interatrial communication. Partial biventricular repair was offered to those with inadequate growth of the RV. RESULTS: The primary procedure was successful in 19 @entity1 in group 1. There was one in-hospital death and two late deaths. Of the remaining 16 survivors, 12 achieved complete biventricular circulation, 7 of whom required no further interventions. Two @entity1 required repeat @entity384 , 1 RVOT reconstruction and 2 transcatheter closure of interatrial communication. Two @entity1 underwent partial biventricular repair. In group 2, there were 3 in-hospital deaths after the primary procedure and 1 @entity1 died four months later. All survivors (n = 10) required a second RV decompression, 8 by @entity384 and 2 by RVOT reconstruction, after which, two @entity1 died. Of the final 8 survivors, 7 achieved complete biventricular circulation, 5 after coil occlusion of the BT shunt and 2 after closure of interatrial communication. CONCLUSIONS: Radiofrequency @entity384 is more efficacious and safe compared with closed pulmonary valvotomy and BT shunt in selected @entity1 with PA-IVS.
