1. Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent.
- Author
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Demkow M, Biernacka EK, Spiewak M, Kowalski M, Siudalska H, Wolski P, Sondergaard L, Miśko J, Hoffman P, and Rużyłło W
- Subjects
- Adult, Echocardiography, Female, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation instrumentation, Humans, Magnetic Resonance Imaging, Male, Poland, Prosthesis Design, Pulmonary Valve Insufficiency diagnosis, Pulmonary Valve Insufficiency etiology, Pulmonary Valve Insufficiency physiopathology, Radiography, Thoracic, Stroke Volume, Time Factors, Treatment Outcome, Ventricular Function, Left, Ventricular Function, Right, Ventricular Outflow Obstruction diagnosis, Ventricular Outflow Obstruction etiology, Ventricular Outflow Obstruction physiopathology, Young Adult, Cardiac Catheterization adverse effects, Cardiac Catheterization instrumentation, Cardiac Surgical Procedures adverse effects, Heart Defects, Congenital therapy, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods, Metals, Pulmonary Valve physiopathology, Pulmonary Valve Insufficiency therapy, Stents, Ventricular Outflow Obstruction therapy
- Abstract
Objectives: To evaluate the effectiveness and safety of percutaneous pulmonary valve implantation (PPVI) with routine prestenting with a bare metal stent (BMS)., Background: PPVI is a relatively new method of treating patients with repaired congenital heart disease (CHD). Results of PPVI performed with routine prestenting have never been reported., Methods: Consecutive patients who underwent PPVI for homograft dysfunction with prestenting with BMS were studied. The schedule of follow-up assessment comprised clinical evaluation, cardiovascular magnetic resonance, transthoracic echocardiography, and chest X-ray to screen for device integrity., Results: PPVI was performed with no serious complications in all patients (n=10, mean age 26.8±4.0 years, 60% males). In nine patients with significant pulmonary stenosis, peak right ventricular outflow tract (RVOT) gradient was reduced from a mean of 80.6±22.7 to 38.8±10.4 mm Hg on the day following implantation (P=0.001). At 1-month and 6-month follow-ups, mean RVOT gradient was 34.0±9.8 and 32.0±12.2 mm Hg, respectively. In patients with significant pulmonary regurgitation, mean pulmonary regurgitation fraction decreased from 19%±6% to 2%±1% (P=0.0008). Relief of RVOT obstruction and restoration of pulmonary valve competence were associated with significant decrease in right ventricular (RV) end-diastolic and end-systolic volumes (125.5±48.6 to 109.2±42.9 mL/m2 ; P=0.002 and 68.4±41.5 vs. 50.9±40.6 mL/m2; P=0.001) as well as improvement in RV ejection fraction (48.8%±13.1% to 57.6%±14.4%; P=0.003) and New York Heart Association class (P=0.003). All patients completed 6-month follow-up. No stent fractures were observed., Conclusions: PPVI with routine prestenting with BMS is a safe and effective method of treatment in patients with repaired CHD., (Copyright © 2010 Wiley-Liss, Inc.)
- Published
- 2011
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