| Abstract: |
Children with valvular pulmonary stenosis have right ventriculardiastolic filling abnormalities, which may be due to either rightventricular hypertrophy or right ventricular outflow tract obstruction. It ispostulated that children with right ventricular hypertrophy caused byvalvular pulmonary stenosis have abnormalities of right ventriculardiastolic filling. Furthermore, if these abnormalities are caused byhypertrophy alone then RY diastolic filling should be unchangedimmediately after successful relief of pulmonary stenosis by PBV(Vermillion et al, 1992 and Pac eta), 2000).This work aimed at assessment of right ventricular diastolicfunctions in congenital severe PS before and after PBY as well asevaluation of the effectofPBY on right ventricular diastolic functions.To achieve these aims, this study was conducted from October2003 to April 2005 and it included 38 patients from whom 26 patientswere included and 12 patients were excluded; only patients with isolatedvalvular PS with a transvalvular systolic gradient > 70 mmHg wereincluded.Before PBY, clinical as well as radiological and BCG evidencesof PS and RYH were clearly demonstrated in our patients. Six monthsihereafter, chest x-ray films and EeG showed significant regression ofRVH with improvement of pulmonary blood flow, yet when comparedwith control subjects, RYW thickness was still significantly increased inpatients with PS.::;;:’.’’- . . ,.”.~,:’,’.”One day before PBY, our patients showed diastolic fillingabnormalities when compared to control subjects. This diastolicdysfunction was evidenced by increased peak A velocity (72.5 vs41.5cm/sec, P<O.OOI), decreased EtA velocity ratio (0.84 vs 1.6,P<O.OO 1), decreased acceleration time of peak E (66A4± 12.21 vs74.S4± 14.06 ms, P<O.OS), and decreased deceleration time of peak E(61.76±12.32 vs 85.9S±13.83 ms, P<O.OOl) in patients versus controlsubjects respectively.
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