{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T10:42:13Z","timestamp":1775731333438,"version":"3.50.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2001,5]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Experience of balloon dilation of peripheral pulmonary stenosis (PPS) in Williams syndrome (WS) is limited.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014Catheterizations in all patients with WS undergoing therapy for PPS from 1984 to 1999 were reviewed. Criteria for successful dilation included an increase &gt;50% in predilation diameter and a decrease &gt;20% in ratio of right ventricular (RV) to aortic (Ao) systolic pressure. Median age and weight were 1.5 years and 9.5 kg. There were 134 dilations during 39 procedures in 25 patients. The success rate for initial dilations was 51%. In multivariate analysis, successful dilation was more likely (1) in distal than in central pulmonary arteries (\n            <jats:italic>P<\/jats:italic>\n            =0.02), (2) if the balloon waist resolved with inflation (\n            <jats:italic>P<\/jats:italic>\n            =0.001), and (3) with larger balloon\/stenosis ratio (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.001). RV pressure was unchanged after dilation (96\u00b130 versus 97\u00b131 mm Hg), primarily because of failure to enlarge central pulmonary arteries. The Ao pressure increased (102\u00b114 versus 109\u00b119 mm Hg,\n            <jats:italic>P<\/jats:italic>\n            =0.03), and the RV\/Ao pressure ratio decreased (0.97\u00b10.34 versus 0.91\u00b10.30,\n            <jats:italic>P<\/jats:italic>\n            =0.05). Aneurysms developed after 24 dilations (18%) and were not related to balloon\/stenosis ratio. Balloon rupture in 12 dilations produced an aneurysm in all 7 cases when rupture was in a hypoplastic segment. Three patients died, none from pulmonary artery trauma, and all before 1994.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014Mortality occurred early in our experience. Despite successful dilation of distal pulmonary arteries, there was modest initial hemodynamic improvement, mainly because of persistent central pulmonary artery obstruction. A serial approach of distal dilations followed by surgical repair of proximal obstruction may be a rational and successful therapy.\n          <\/jats:p>","DOI":"10.1161\/01.cir.103.17.2165","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:09:32Z","timestamp":1339459772000},"page":"2165-2170","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":91,"title":["Balloon Dilation Angioplasty of Peripheral Pulmonary Stenosis Associated With Williams Syndrome"],"prefix":"10.1161","volume":"103","author":[{"given":"Robert L.","family":"Geggel","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberlee","family":"Gauvreau","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Lock","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Children\u2019s Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Mass."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.33.12.986"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80696-1"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02310569"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002469900195"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002469900125"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90902-B"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)91391-I"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90205-F"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38659-3"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(87)90764-2"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8183.1998.tb00136.x"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(84)80146-0"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8651(18)30438-7"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0304(199605)38:1<16::AID-CCD5>3.0.CO;2-6"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/ng0993-11"},{"key":"e_1_3_1_16_2","doi-asserted-by":"crossref","unstructured":"Lang P. 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