Purpose:To evaluate balloon pulmonary valvuloplasty (BPV) effectiveness for neonatal and nursing infants with tetralogy of Fallot (ToF). Subjects and Methods:Tirty-five neonatal to early nursing infants with Tof undergoing BPV were examined for changes in oxygen saturation, pulmonary valve (PV) diameter, pulmonary vascular tree diameter [Nakata’s PA index (PAI)], and pulmonary arterial valve regurgitation (PR), as well as effects on a radical operation.
Results: At the BPV, ages ranged from 5-95days (median 27), body weights from 2.1-5.6 kg (3.4), PV diameters from 3.5-6.6 mm (5.5), and PAI from 74-306 (136). A balloon equivalent to 80-157% (121%) of PV diameter was used. β-blocker administration was given after surgery. Mild pulmonary edema was observed in 1 case and right ventricle outflow tract dissection in 1. SpO2 was significantly elevated from preoperative 86.6±7.7% to postoperative 94.6±4.6%. However, it declined to 85.8±7.8% before the radical operation. Pulmonary valve area (PVA) increased from 69.3±13.8% (normal) before BPV to 87.0±20.4% before the radical operation. PAI increased in all cases from mean 163 to 339. A radical operation was completed in 31 subjects, of whom 18 required a transannular patch repair. An m-BT shunt operation was performed in 2 with repeated cyanotic fits and 1 with pulmonary coarctation while waiting for the radical operation. One with Down’s syndrome died from pneumonia while waiting for the radical operation. Conclusion: BPV has limitations for avoiding transannular patch repair, as SpO2 was elevated and the pulmonary vascular tree and annulus increased following the procedure.