ArticleBMC cardiovascular disorders2026
Off-pump pulmonary valvotomy for pulmonary atresia with intact ventricular septum: a safe and effective alternative with comparable outcomes.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRight ventricle (RV) decompression for pulmonary atresia with intact ventricular septum (PA/IVS) could be achieved surgically or percutaneously, yet transcatheter valvotomy is not widely accessible in remote regions and classic on-pump pulmonary valvotomy procedure carries risks of by pass in neonatal patients. We aim to summarize our 15-year’s surgical experience treating PA/IVS with on-pump valvulotomy, off-pump valvulotomy and hybrid techniques.
methodsFrom January 2010 to March 2025, 104 PA/IVS children who underwent off-pump, on-pump pulmonary valvulotomy or hybrid therapy in our hospital were retrospectively reviewed, including off-pump group (n = 56), on-pump group (n = 34) and hybrid group (n = 14). The postoperative mortality, operation time, early and mid-term follow-up of the three groups were analyzed.
resultsBoth the off-pump and hybrid groups exhibited significantly shorter operative times, reduced vasoactive drug support, shorter intubation times, and shorter intensive care unit (ICU) and postoperative hospital stays compared to the on-pump group (P < 0.001). Cerebral, intestinal and renal oxygen monitor suggested that no obvious hypoxia was caused by clamping in off-pump procedure (P > 0.05). At final follow-up, RV hypoplasia, tricuspid Z score and pulmonary regurgitation were not significant among groups (P > 0.05). However, the hybrid group demonstrated a significantly higher rate of restenosis.
conclusionsThe off-pump pulmonary valvotomy is an effective, safe and technical-friendly operation. It provides superior early outcomes compared to on-pump surgery and a lower restenosis rate relative to hybrid techniques, highlighting its value for broader adoption across medical centers.
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