A Management Strategy for Mild Valvar Pulmonary Stenosis
Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Drossner, David M. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2008 |
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| Schlagwörter: |
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| Anmerkung: |
© Springer Science+Business Media, LLC 2008 |
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| Übergeordnetes Werk: |
Enthalten in: Pediatric cardiology - New York, NY : Springer, 1979, 29(2008), 3 vom: 10. Jan., Seite 649-652 |
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| Übergeordnetes Werk: |
volume:29 ; year:2008 ; number:3 ; day:10 ; month:01 ; pages:649-652 |
| Links: |
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| DOI / URN: |
10.1007/s00246-007-9191-y |
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SPR002781433 |
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| 520 | |a Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. | ||
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10.1007/s00246-007-9191-y doi (DE-627)SPR002781433 (SPR)s00246-007-9191-y-e DE-627 ger DE-627 rakwb eng Drossner, David M. verfasserin aut A Management Strategy for Mild Valvar Pulmonary Stenosis 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media, LLC 2008 Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. Pulmonary valve stenosis (dpeaa)DE-He213 Valvar pulmonary stenosis (dpeaa)DE-He213 Congenital heart disease (dpeaa)DE-He213 Mahle, William T. aut Enthalten in Pediatric cardiology New York, NY : Springer, 1979 29(2008), 3 vom: 10. Jan., Seite 649-652 (DE-627)254638848 (DE-600)1463000-X 1432-1971 nnns volume:29 year:2008 number:3 day:10 month:01 pages:649-652 https://dx.doi.org/10.1007/s00246-007-9191-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2008 3 10 01 649-652 |
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10.1007/s00246-007-9191-y doi (DE-627)SPR002781433 (SPR)s00246-007-9191-y-e DE-627 ger DE-627 rakwb eng Drossner, David M. verfasserin aut A Management Strategy for Mild Valvar Pulmonary Stenosis 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media, LLC 2008 Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. Pulmonary valve stenosis (dpeaa)DE-He213 Valvar pulmonary stenosis (dpeaa)DE-He213 Congenital heart disease (dpeaa)DE-He213 Mahle, William T. aut Enthalten in Pediatric cardiology New York, NY : Springer, 1979 29(2008), 3 vom: 10. Jan., Seite 649-652 (DE-627)254638848 (DE-600)1463000-X 1432-1971 nnns volume:29 year:2008 number:3 day:10 month:01 pages:649-652 https://dx.doi.org/10.1007/s00246-007-9191-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2008 3 10 01 649-652 |
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10.1007/s00246-007-9191-y doi (DE-627)SPR002781433 (SPR)s00246-007-9191-y-e DE-627 ger DE-627 rakwb eng Drossner, David M. verfasserin aut A Management Strategy for Mild Valvar Pulmonary Stenosis 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media, LLC 2008 Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. Pulmonary valve stenosis (dpeaa)DE-He213 Valvar pulmonary stenosis (dpeaa)DE-He213 Congenital heart disease (dpeaa)DE-He213 Mahle, William T. aut Enthalten in Pediatric cardiology New York, NY : Springer, 1979 29(2008), 3 vom: 10. Jan., Seite 649-652 (DE-627)254638848 (DE-600)1463000-X 1432-1971 nnns volume:29 year:2008 number:3 day:10 month:01 pages:649-652 https://dx.doi.org/10.1007/s00246-007-9191-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2008 3 10 01 649-652 |
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10.1007/s00246-007-9191-y doi (DE-627)SPR002781433 (SPR)s00246-007-9191-y-e DE-627 ger DE-627 rakwb eng Drossner, David M. verfasserin aut A Management Strategy for Mild Valvar Pulmonary Stenosis 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media, LLC 2008 Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. Pulmonary valve stenosis (dpeaa)DE-He213 Valvar pulmonary stenosis (dpeaa)DE-He213 Congenital heart disease (dpeaa)DE-He213 Mahle, William T. aut Enthalten in Pediatric cardiology New York, NY : Springer, 1979 29(2008), 3 vom: 10. Jan., Seite 649-652 (DE-627)254638848 (DE-600)1463000-X 1432-1971 nnns volume:29 year:2008 number:3 day:10 month:01 pages:649-652 https://dx.doi.org/10.1007/s00246-007-9191-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2008 3 10 01 649-652 |
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10.1007/s00246-007-9191-y doi (DE-627)SPR002781433 (SPR)s00246-007-9191-y-e DE-627 ger DE-627 rakwb eng Drossner, David M. verfasserin aut A Management Strategy for Mild Valvar Pulmonary Stenosis 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer Science+Business Media, LLC 2008 Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. Pulmonary valve stenosis (dpeaa)DE-He213 Valvar pulmonary stenosis (dpeaa)DE-He213 Congenital heart disease (dpeaa)DE-He213 Mahle, William T. aut Enthalten in Pediatric cardiology New York, NY : Springer, 1979 29(2008), 3 vom: 10. Jan., Seite 649-652 (DE-627)254638848 (DE-600)1463000-X 1432-1971 nnns volume:29 year:2008 number:3 day:10 month:01 pages:649-652 https://dx.doi.org/10.1007/s00246-007-9191-y lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 29 2008 3 10 01 649-652 |
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Enthalten in Pediatric cardiology 29(2008), 3 vom: 10. Jan., Seite 649-652 volume:29 year:2008 number:3 day:10 month:01 pages:649-652 |
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Enthalten in Pediatric cardiology 29(2008), 3 vom: 10. Jan., Seite 649-652 volume:29 year:2008 number:3 day:10 month:01 pages:649-652 |
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Pulmonary valve stenosis Valvar pulmonary stenosis Congenital heart disease |
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Drossner, David M. @@aut@@ Mahle, William T. @@aut@@ |
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In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. 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Drossner, David M. |
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Drossner, David M. misc Pulmonary valve stenosis misc Valvar pulmonary stenosis misc Congenital heart disease A Management Strategy for Mild Valvar Pulmonary Stenosis |
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A Management Strategy for Mild Valvar Pulmonary Stenosis Pulmonary valve stenosis (dpeaa)DE-He213 Valvar pulmonary stenosis (dpeaa)DE-He213 Congenital heart disease (dpeaa)DE-He213 |
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A Management Strategy for Mild Valvar Pulmonary Stenosis |
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management strategy for mild valvar pulmonary stenosis |
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A Management Strategy for Mild Valvar Pulmonary Stenosis |
| abstract |
Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. © Springer Science+Business Media, LLC 2008 |
| abstractGer |
Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. © Springer Science+Business Media, LLC 2008 |
| abstract_unstemmed |
Abstract Pulmonary valve stenosis (PVS) is a common congenital cardiac lesion, 1/1000 live-births, the majority of patients having mild transvalvar gradients. In the present study, we sought to determine the outcome of mild PVS diagnosed by echocardiography and to propose a management algorithm that would identify patients at risk for progression of PVS, yet reduce health care expenditures. In this single-center retrospective study, we included all patients who met the following criteria: first diagnosed with PVS at <10 years of age, an initial peak systolic Doppler gradient of ≤40 mm Hg, no additional congenital heart lesions, and at least two clinical evaluations. There were 146 subjects who met these criteria. The median age at initial diagnosis was 3.9 months, with a range of 1 day to 9.9 years. The average initial peak systolic gradient (PSG) was 23.3 mm Hg (±7.8) and final PSG 17.1 mm Hg (±10.3). Over a mean length of follow-up of 4.0 years, 107/146 (73%) were later reported to have very mild PVS (PSG ≤ 25 mm Hg, no clinical change or resolution of murmur). Only 3 of 146 subjects progressed to have a PSG above 40 mm Hg, with 1 undergoing a balloon valvuloplasty. In conclusion, mild PVS diagnosed in early childhood is a benign lesion, with most children essentially demonstrating resolution in the first years of life. Mild PVS identified in infancy requires a brief period of close observation. Based on these data, our management recommendations are that infants be followed closely within the first year of life. Young infants diagnosed at birth that maintain a PSG ≤ 25 mm Hg at more than 6 months of age as well as those who are older than 1 year of age with a PSG ≤ 40 mm Hg have a benign course and the utility of ongoing cardiology follow-up is questionable. © Springer Science+Business Media, LLC 2008 |
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A Management Strategy for Mild Valvar Pulmonary Stenosis |
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| score |
7.398184 |