الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Pulmonary Stenosis (PS) is the second most common congenital heart malformation. Since 1982, the treatment of choice for PS is balloon pulmonary valvuoplasty (BPV). It is thought that dynamic right ventricular outflow tract obstruction (RVOTO) contributes to morbidity and mortality following BPV. There is no clear consensus on the routine administration of beta blocking agents after BPV to counteract this dynamic stenosis. Objective: This study aims to determine the role of beta blockers following BPV on cardiac hemodynamics. Material and Methods: Fifty patients presenting for elective BPV were prospectively randomized into two arms: BB arm receiving 2 mg/kg of propranolol daily in two divided doses for one month, while the placebo arm received age-appropriate vitamin supplements. Data was collected from the pre-BPV echocardiography study, during the BPV procedure, at 24-hours post-BPV and at 1-month post BPV. Functional capacity was compared prior to BPV and at 1-month after BPV; RV echocardiographic parameters were compared at 24-hours and at 1-month post procedure. All data was gathered, statistically analyzed and tabulated and compared using appropriate statistical approaches. Results: Comparison made between the two study arms revealed no significant difference between functional capacity and the echocardiographic parameters obtained at 24-hours post-BPV. Mean PG was 10.76 for placebo arm and 8.04 for the BB arm, and mean RVOT diameter was 4.14 for the placebo arm and 4.89 for the BB arm. Comparison made between the two study arms revealed no significant difference between functional capacity and the echocardiographic parameters obtained at 1 month post-BPV. Mean PG was 14.92 for placebo arm and 11.40 for the BB arm, and mean RVOT diameter was 4.14 for the placebo arm and 4.95 for the BB arm. Regarding percent change from data collected at 24 hours and data collected at 1 month post-BPV, no significant changes were found between the placebo arm and the BB arm. Comparing the median percent change for the placebo arm to the BB arm, FC was 18.75% and 14.29%, RVOT was -2% and 3% and PG was 33.93% and 25%, respectively. Conclusion: no significant difference in the short term follow up following BPV of functional capacity and RV echocardiographic parameters between BB therapy and placebo. |