الفهرس 
Pulmonary stenosis(PS)Only 14 pages are availabe for public view
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Abstract
Despite the importance of assessing RV function in many cardiac conditions especially the pediatric age group, evaluation of RV function remains difficult due to complex geometry of this chamber. The development of new quantitative echocardiographic techniques such as ultrasonic strain & strain rate (SR) imaging, has enhanced the ability to non invasively assessing regional RV function. Strain representing the relative magnitude of segmental systolic shortening and its temporal derivative, the Strain rate (SR) i.e. the maximal velocity of systolic shortening, is considered as an accurate index of myocardial contractility, It is not dependent on adjacent myocardial motion or heart translation.
Balloon pulmonary valvuloplasty is considered the treatment of choice for patient with isolated valvular pulmonary stenosis, so assessment of success of this procedure is of great importance.
The aim of this study was to use these strain and strain rate parameters in assessment of RV regional functions immediately and short term after BPV in comparison to preprocedural parameters.
This study was conducted on 30 patients with congenital isolated valvular pulmonary stenosis , who were referred to the cardiology department in Ain Shams University Hospitals for balloon pulmonary valvuloplasty, in the period between March, 2006 and june, 2006, excluding from them patients with other congenital anomalies or patients with other causes that might affect RV function, patient with subvalvular or supravalvular PS or patients with general illness that might prevent possible intervention.
Every patient was subjected to history taking, full clinical examination, 12 leads surface ECG, plain X-ray chest, full echocardiographic study (2-D, M mode and Doppler study), RV regional longitudinal function & myocardial deformation properties using strain and strain rate imaging and analysis techniques pre-balloon dilatation, Balloon pulmonary valvuloplasty using standard techniques, assessment of pressure gradient, strain and strain rate parameters immediately & in the short term (one month) post-balloon dilatation.
In the present study all patients who underwent BPV had successful results with significant DROP of the peak systolic pressure gradient across pulmonary valve immediately and more DROP in the short term post BPV.
There was significant improvement in systolic and diastolic strain rate parameters immediately and short term post BPV in comparison to the preprocedural parameters. The improvement in diastolic function was more evident in the immediately post results.
There was significant improvement in systolic strain measurement immediately and short term post BPV in comparison to the preprocedural measurement.
All the parameters measured were improved more in the short term results more than the immediately post results.