Document Detail


[Percutaneous catheter-based implantation of artificial pulmonary valves in patients with congenital heart defects].
MedLine Citation:
PMID:  21725388     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous catheter-based implantation of artificial heart valves is a new technique that may supplement surgery and which may be used more in the future. We here report our first experience with implantation of artificial pulmonary valves in children with congenital heart defects.
MATERIAL AND METHODS: Eligible patients were those with symptoms of heart failure combined with stenosis and/or insufficiency in an established artificial right ventricular outflow tract. The valve was inserted through a catheter from a vein in the groin or neck. Symptoms, echocardiography, invasive measurements and angiography were assessed for evaluation of treatment effect. Our treatment results are reported for the period April 2007-September 2009.
RESULTS: Ten patients (seven men and three women, median age 17 years) were assessed. The procedure reduced pressure in the right ventricle (p = 0.008) and resolved the pulmonary insufficiency in all patients. The median time in hospital was two days. No patients had complications that were directly associated with the implantation procedure. One patient developed a pseudoaneurysm in the femoral artery, another had a short-lasting fever two days after the procedure and one patient experienced a stent fracture that required surgery 9 months after the implantation. After 6 months all patients had a reduced pressure gradient in the right ventricular outflow tract (p = 0.008), the pulmonary insufficiency had improved (p = 0.006) and they all reported improval of symptoms. These results persisted for at least 24 months for the four patients who were monitored until then.
INTERPRETATION: Percutaneous catheter-based implantation of artificial pulmonary valves improves hemodynamics in the right ventricle of selected patients with congenital heart defects. A randomized controlled study should be undertaken to provide a stronger evidence-base for usefulness of this procedure.
Authors:
Vegard Bruun Wyller; Lars Aaberge; Erik Thaulow; Gaute Døhlen
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række     Volume:  131     ISSN:  0807-7096     ISO Abbreviation:  Tidsskr. Nor. Laegeforen.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-04     Completed Date:  2011-09-29     Revised Date:  2011-12-09    
Medline Journal Info:
Nlm Unique ID:  0413423     Medline TA:  Tidsskr Nor Laegeforen     Country:  Norway    
Other Details:
Languages:  nor     Pagination:  1289-93     Citation Subset:  IM    
Affiliation:
Hjerte-, lunge- og allergiseksjonen, Oslo universitetssykehus, Rikshospitalet, Norway.
Vernacular Title:
Perkutan kateterbasert innsetting av kunstig pulmonalklaff ved medfødt hjertefeil.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Catheterization / adverse effects,  methods
Child
Clinical Competence
Coronary Angiography
Evidence-Based Medicine
Female
Follow-Up Studies
Heart Defects, Congenital / surgery*
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation* / adverse effects,  instrumentation,  methods
Humans
Male
Patient Selection
Pulmonary Valve / surgery*
Pulmonary Valve Insufficiency / congenital,  surgery*
Pulmonary Valve Stenosis / congenital,  surgery*
Treatment Outcome
Comments/Corrections
Comment In:
Tidsskr Nor Laegeforen. 2011 Nov 1;131(21):2109   [PMID:  22048197 ]

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