الفهرس 
Pulmonary stenosisOnly 14 pages are availabe for public view
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Abstract
Recent investigations have introduced a Doppler tissue imaging (DTI) echocardiography as a new non-invasive simple method for assessing the ventricular systolic and diastolic function that can solve the limitation of the traditional methods in evaluating the ventricular function Our study had supported the use of DTI in evaluation of regional myocardial function in patients with isolated valvular pulmonary stenosis before and after successful balloon pulmonary valvuloplasty The aim of the present study was to evaluate regional myocardial performance using PW-DTI in pediatric patient with isolated pulmonary valve stenosis. Second, to detect early functional changes in regional myocardial functions in these patients with apparently good global myocardial function. Third, find a new reliable indication for intervention in pediatric patient with isolated pulmonary valve stenosis. Forth, to show the effect of right ventricle obstruction relief by balloon valvuloplasty on regional myocardial motion behaviors (systolic and diastolic functions). Finally To evaluate our experience in balloon pulmonary valvuloplasty. The study included 20 patients with isolated valvular pulmonary stenosis. Their age (at time of BPV) was 2.50 1.21 years. Their weight was 13.14 1.21 Kg and their body surface area was 0.55 0.12 m2. They were 50% males and 50% females. Forty five % of this group was presented with Dyspnea and 55% were asymptomatic and discovered accidentally during routine examination. Right ventricular hypertrophy was demonstrated on ECG recording in all patient of this group (100%). The procedure of BPV was performed in all patients. The peak instantaneous pressure gradient before the dilatation showed a mean of (81.66 29.96) mmHg by CWD and peak to peak gradient at time of cardiac catheterization was (76.45 29.16) mmHg and dropped immediately after BPV to (20.50 7.39) mmHg. After six moths follow up the peak instantaneous gradient was (20.20 8.97) mmHg. The major significant change was the growth of the pulmonary annulus from (10.33 4.34) mm before dilatation to (14.07 1.51) mm six moths after BPV. DTI used to evaluate the regional systolic and diastolic function before and after BPV. We found improvement of right ventricular regional systolic function as evident by increased tricuspid annular systolic velocity from (9.79 2.14) cm/sec before dilatation to (11.97 2.31) cm/sec six moths after successful BPV. Also improvement of regional right diastolic dysfunction was reported as evident by increased tricuspid annular early diastolic velocity from (10.77 3.08) cm/sec to 14.39 2.90 cm/sec and increased tricuspid annular E`/A` ratio from (0.98 0.37) to (1.43 0.25) six months after balloon dilatation. We did not report abnormal left ventricular regional systolic or diastolic function either before or after BPV. Also we did not report abnormal global right or left ventricular function either by conventional methods or by DTI before or after BPV. So we can conclude that DTI is safe, effective non invasive tool for evaluation of regional myocardial function and its value in decision making for BPV.