eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
3/2020
vol. 16
 
Share:
Share:
more
 
 
abstract:
Special paper

Transcatheter pulmonary valve implantation in 100 patients: a 10-year single-center experience

Witold Rużyłło
1
,
Elżbieta K. Biernacka
2
,
Olgierd Woźniak
2
,
Mirosław Kowalski
2
,
Mateusz Śpiewak
3
,
Alicja Cicha-Mikołajczyk
4
,
Aleksander Szczęsny
2
,
Mariusz Kuśmierczyk
5
,
Piotr Hoffman
2
,
Marcin Demkow
1

1.
Department of Coronary and Structural Heart Diseases, The Cardinal Stefan Wyszyński National Institute of Cardiology, Warsaw, Poland
2.
Department of Congenital Heart Diseases, The Cardinal Stefan Wyszyński National Institute of Cardiology, Warsaw, Poland
3.
Department of Radiology, The Cardinal Stefan Wyszyński National Institute of Cardiology, Warsaw, Poland
4.
Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, The Cardinal Stefan Wyszyński National Institute of Cardiology, Warsaw, Poland
5.
Department of Cardiac Surgery and Transplantology, The Cardinal Stefan Wyszyński National Institute of Cardiology, Warsaw, Poland
Adv Interv Cardiol 2020; 16, 3 (61): 235–243
Online publish date: 2020/10/02
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Transcatheter pulmonary valve implantation (TPVI) is a non-surgical method of treatment for patients with right ventricular outflow tract (RVOT) dysfunction after surgical repair of congenital heart defects (CHD). 

Aim
To evaluate the long-term results of TPVI performed in a single center.

Material and methods
Over 10 years, TPVI was performed in 100 patients (mean age: 26.4 ±8.1 years), using Melody Medtronic or Sapien Edwards valves.

Results
The initial success rate of TPVI was 93%. In 7 cases (5 urgent), a switch to surgical intervention was necessary due to periprocedural complications (all patients survived). Following TPVI, none of the 93 patients had severe pulmonary regurgitation. The pulmonary gradient decreased from 49.0 ±37.8 before to 27.6 ±14.9 mm Hg directly after TPVI (p < 0.0001). Right ventricular end-diastolic volume decreased, while NYHA class and pVO2 uptake significantly improved in 1 year after TPVI. Freedom from reintervention was 100% in 1 year. Freedom from serious adverse events was 86% in mean 5.5 years of observation. The main reason for reintervention was infective endocarditis (IE) (1.6% patients/year). Increased risk of IE was associated with severe PS before valve implantation and the suboptimal result of TPVI. The incidence of IE seems to be lower in patients treated permanently with antiplatelet therapy (1.8% vs. 0.9% patients/year, NS).

Conclusions
TPVI is a safe and effective method of treatment in patients with RVOT dysfunction after surgical correction of CHD. To achieve a good outcome, precise patient selection and rigorous IE prevention are necessary.

keywords:

congenital heart disease, pulmonary stenosis, pulmonary regurgitation

Quick links
© 2020 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe