The Experts below are selected from a list of 279 Experts worldwide ranked by ideXlab platform
P S Rao - One of the best experts on this subject based on the ideXlab platform.
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results of three to 10 year follow up of Balloon Dilatation of the pulmonary valve
Heart, 1998Co-Authors: Omar Galal, P S Rao, Madhavi Patnana, S H Buck, Allen D WilsonAbstract:Background—The results of immediate and short term follow up of Balloon Dilatation of the pulmonary valve have been well documented, but there is limited information on long term follow up. Objective—To evaluate the results of three to 10 year follow up of Balloon Dilatation of the pulmonary valve in children and adolescents. Setting—Tertiary care centre/university hospital. Design—Retrospective study. Methods and results—85 patients (aged between 1 day and 20 years, mean (SD) 7.0 (6.4) years) underwent Balloon Dilatation of the pulmonary valve during an 11 year period ending August 1994. There was a resultant reduction in the peak to peak gradient from 87 (38) to 26 (22) mm Hg. Immediate surgical intervention was not required. Residual gradients of 29 (17) mm Hg were measured by catheterisation (n = 47) and echo Doppler (n = 82) at intermediate term follow up (two years). When individual results were scrutinised, nine of 82 patients had restenosis, defined as a peak gradient of 50 mm Hg or more. Seven of these patients underwent repeat Balloon Dilatation of the pulmonary valve: peak gradients were reduced from 89 (40) to 38 (20) mm Hg. Clinical evaluation and echo Doppler data of 80 patients showed that residual peak instantaneous Doppler gradients were 17 (15) mm Hg at long term follow up (three to 10 years, median seven), with evidence for late restenosis in one patient (1.3%). Surgical intervention was necessary to relieve fixed infundibular stenosis in three patients and supravalvar pulmonary stenosis in one. Repeat Balloon Dilatation was performed to relieve restenosis in two patients. Actuarial reintervention free rates at one, two, five, and 10 years were 94%, 89%, 88%, and 84%, respectively. Pulmonary valve regurgitation was noted in 70 of 80 patients at late follow up, but neither right ventricular Dilatation nor paradoxical interventricular septal motion developed. Conclusions—The results of late follow up of Balloon Dilatation of the pulmonary valve are excellent. Repeat Balloon Dilatation was performed in 11% of patients and surgical intervention for subvalvlar or supravalvar stenosis in 5%. Most patients had mild residual pulmonary regurgitation but right ventricular volume overload did not develop and surgical intervention was not required. Balloon Dilatation is the treatment of choice in the management of moderate to severe stenosis of the pulmonary valve. Further follow up studies should be undertaken to evaluate the significance of residual pulmonary regurgitation. Keywords: Balloon Dilatation of the pulmonary valve; pulmonary stenosis; pulmonary regurgitation
Tunde A Odutoye - One of the best experts on this subject based on the ideXlab platform.
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S153 – Radiological Balloon Dilatation of Neo-Pharyngeal Strictures:
Otolaryngology-Head and Neck Surgery, 2008Co-Authors: Robert Harris, Grundy Alan, Tunde A OdutoyeAbstract:ObjectivesRadiological Balloon Dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological Dilatation of pharyngeal and upper oesophageal strictures and less still on radiological Balloon Dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological Balloon Dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy.MethodsA tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent Balloon Dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure.Results5 patients gained relief of their dysphag...
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S153 – Radiological Balloon Dilatation of Neo-Pharyngeal Strictures
Otolaryngology–Head and Neck Surgery, 2008Co-Authors: Robert L Harris, Grundy Alan, Tunde A OdutoyeAbstract:Objectives Radiological Balloon Dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological Dilatation of pharyngeal and upper oesophageal strictures and less still on radiological Balloon Dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological Balloon Dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. Methods A tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent Balloon Dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure. Results 5 patients gained relief of their dysphagia with 1 Balloon Dilatation only. 9 patients required more than 1 Dilatation to maintain swallowing. 2 patients had Balloon Dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. 3 patients failed to maintain swallowing with repeat Dilatations. No patients suffered any significant complications such as perforation. Conclusions Balloon Dilatation is minimally invasive and less traumatic than rigid pharyngoscopy with bouginage Dilatation. It is well tolerated. It may be repeated frequently and can successfully relieve strictures of the pharynx in patients who have undergone total laryngectomy or pharyngolaryngectomy.
Karouk Said - One of the best experts on this subject based on the ideXlab platform.
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no superiority of stents vs Balloon Dilatation for dominant strictures in patients with primary sclerosing cholangitis
Gastroenterology, 2018Co-Authors: Cyriel Y Ponsioen, Urban Arnelo, Annika Bergquist, Erik A J Rauws, Vemund Paulsen, P Cantu, I Parzanese, Elisabeth M G De Vries, Kim N Van Munster, Karouk SaidAbstract:Background & Aims Dominant strictures occur in approximately 50% of patients with primary sclerosing cholangitis (PSC). Short-term stents have been reported to produce longer resolution of dominant strictures than single-Balloon Dilatation. We performed a prospective study to compare the efficacy and safety of Balloon Dilatation vs short-term stents in patients with non–end-stage PSC. Methods We performed an open-label trial of patients with PSC undergoing therapeutic endoscopic retrograde cholangiopancreatography (ERCP) at 9 tertiary-care centers in Europe, from July 2011 through April 2016. Patients found to have a dominant stricture during ERCP were randomly assigned to groups that underwent Balloon Dilatation (n = 31) or stent placement for a maximum of 2 weeks (n = 34); patients were followed for 24 months. The primary outcome was the cumulative recurrence-free patency of the primary dominant strictures. Results Study recruitment was terminated after a planned interim analysis because of futility and differences in treatment-related serious adverse events (SAEs) between groups. The cumulative recurrence-free rate did not differ significantly between groups (0.34 for the stent group and 0.30 for the Balloon Dilatation group at 24 months; P = 1.0). Most patients in both groups had reductions in symptoms at 3 months after the procedure. There were 17 treatment-related SAEs: post-ERCP pancreatitis in 9 patients and bacterial cholangitis in 4 patients. SAEs occurred in 15 patients in the stent group (45%) and in only 2 patients in the Balloon Dilatation group (6.7%) (odds ratio, 11.7; 95% confidence interval, 2.4–57.2; P = .001). Conclusions In a multicenter randomized trial of patients with PSC and a dominant stricture, short-term stents were not superior to Balloon Dilatation and were associated with a significantly higher occurrence of treatment-related SAEs. Balloon Dilatation should be the initial treatment of choice for dominant strictures in patients with PSC. This may be particularly relevant to patients with an intact papilla. ClinicalTrials.gov no. NCT01398917 .
Faguang Jin - One of the best experts on this subject based on the ideXlab platform.
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Application of Electrocautery Needle Knife Combined with Balloon Dilatation versus Balloon Dilatation in the Treatment of Tracheal Fibrotic Scar Stenosis
Respiration; international review of thoracic diseases, 2017Co-Authors: Min Chen, Faguang JinAbstract:BACKGROUND Electrocautery needle knives can largely reduce scar and granulation tissue hyperplasia and play an important role in treating patients with benign stricture. OBJECTIVE The aim of this retrospective study was to evaluate the efficacy and safety of electrocautery needle knife combined with Balloon Dilatation versus Balloon Dilatation alone in the treatment of tracheal stenosis caused by tracheal intubation or tracheotomy. METHODS We retrospectively analysed the clinical data of 43 patients with tracheal stenosis caused by tracheotomy or tracheal intubation in our department from January 2013 to January 2016. Among these 43 patients, 23 had simple web-like stenosis and 20 had complex steno sis. All patients were treated under general anaesthesia, and the treatment methods were (1) Balloon Dilatation alone, (2) needle knife excision of fibrotic tissue combined with Balloon Dilatation, and (3) needle knife radial incision of fibrotic tissue combined with Balloon Dilatation. RESULTS After treatment the symptoms, such as shortness of breath, were markedly improved immediately in all cases. The stenosis degree of patients who were treated with the elec-trocautery needle knife combined with Balloon Dilatation had better improvement compared with that of those treated with Balloon Dilatation treatment alone after 3 months (0.45 ± 0.04 vs. 0.67 ± 0.05, p < 0.01), and the proportion of restenosis occurrence that required further treatment was decreased at 6 months (46.9 vs. 81.8%), especially for the web-like stenosis patients, as most of their stenoses dilated with no obvious restenosis and achieved clinical cure. CONCLUSION Electrocautery needle knife combined with Balloon Dilatation is an effective and safe treatment for tracheal fibrotic stenosis compared with Balloon Dilatation alone.
Allen D Wilson - One of the best experts on this subject based on the ideXlab platform.
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results of three to 10 year follow up of Balloon Dilatation of the pulmonary valve
Heart, 1998Co-Authors: Omar Galal, P S Rao, Madhavi Patnana, S H Buck, Allen D WilsonAbstract:Background—The results of immediate and short term follow up of Balloon Dilatation of the pulmonary valve have been well documented, but there is limited information on long term follow up. Objective—To evaluate the results of three to 10 year follow up of Balloon Dilatation of the pulmonary valve in children and adolescents. Setting—Tertiary care centre/university hospital. Design—Retrospective study. Methods and results—85 patients (aged between 1 day and 20 years, mean (SD) 7.0 (6.4) years) underwent Balloon Dilatation of the pulmonary valve during an 11 year period ending August 1994. There was a resultant reduction in the peak to peak gradient from 87 (38) to 26 (22) mm Hg. Immediate surgical intervention was not required. Residual gradients of 29 (17) mm Hg were measured by catheterisation (n = 47) and echo Doppler (n = 82) at intermediate term follow up (two years). When individual results were scrutinised, nine of 82 patients had restenosis, defined as a peak gradient of 50 mm Hg or more. Seven of these patients underwent repeat Balloon Dilatation of the pulmonary valve: peak gradients were reduced from 89 (40) to 38 (20) mm Hg. Clinical evaluation and echo Doppler data of 80 patients showed that residual peak instantaneous Doppler gradients were 17 (15) mm Hg at long term follow up (three to 10 years, median seven), with evidence for late restenosis in one patient (1.3%). Surgical intervention was necessary to relieve fixed infundibular stenosis in three patients and supravalvar pulmonary stenosis in one. Repeat Balloon Dilatation was performed to relieve restenosis in two patients. Actuarial reintervention free rates at one, two, five, and 10 years were 94%, 89%, 88%, and 84%, respectively. Pulmonary valve regurgitation was noted in 70 of 80 patients at late follow up, but neither right ventricular Dilatation nor paradoxical interventricular septal motion developed. Conclusions—The results of late follow up of Balloon Dilatation of the pulmonary valve are excellent. Repeat Balloon Dilatation was performed in 11% of patients and surgical intervention for subvalvlar or supravalvar stenosis in 5%. Most patients had mild residual pulmonary regurgitation but right ventricular volume overload did not develop and surgical intervention was not required. Balloon Dilatation is the treatment of choice in the management of moderate to severe stenosis of the pulmonary valve. Further follow up studies should be undertaken to evaluate the significance of residual pulmonary regurgitation. Keywords: Balloon Dilatation of the pulmonary valve; pulmonary stenosis; pulmonary regurgitation
