Document Detail

Percutaneous pulmonary valve implantation: impact of evolving technology and learning curve on clinical outcome.
MedLine Citation:
PMID:  18391109     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Percutaneous pulmonary valve implantation was introduced in the year 2000 as a nonsurgical treatment for patients with right ventricular outflow tract dysfunction.
METHODS AND RESULTS: Between September 2000 and February 2007, 155 patients with stenosis and/or regurgitation underwent percutaneous pulmonary valve implantation. This led to significant reduction in right ventricular systolic pressure (from 63+/-18 to 45+/-13 mm Hg, P<0.001) and right ventricular outflow tract gradient (from 37+/-20 to 17+/-10 mm Hg, P<0.001). Follow-up ranged from 0 to 83.7 months (median 28.4 months). Freedom from reoperation was 93% (+/-2%), 86% (+/-3%), 84% (+/-4%), and 70% (+/-13%) at 10, 30, 50, and 70 months, respectively. Freedom from transcatheter reintervention was 95% (+/-2%), 87% (+/-3%), 73% (+/-6%), and 73% (+/-6%) at 10, 30, 50, and 70 months, respectively. Survival at 83 months was 96.9%. On time-dependent analysis, the first series of 50 patients (log-rank test P<0.001) and patients with a residual gradient >25 mm Hg (log-rank test P=0.01) were associated with a higher risk of reoperations.
CONCLUSIONS: Percutaneous pulmonary valve implantation resulted in the ability to avoid surgical right ventricular outflow tract revision in the majority of cases. This procedure might reduce the number of operations needed over the total lifetime of patients with right ventricle-to-pulmonary artery conduits.
Philipp Lurz; Louise Coats; Sachin Khambadkone; Johannes Nordmeyer; Younes Boudjemline; Silvia Schievano; Vivek Muthurangu; Twin Yen Lee; Giovanni Parenzan; Graham Derrick; Seamus Cullen; Fiona Walker; Victor Tsang; John Deanfield; Andrew M Taylor; Philipp Bonhoeffer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-04-07
Journal Detail:
Title:  Circulation     Volume:  117     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-16     Completed Date:  2008-05-07     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1964-72     Citation Subset:  AIM; IM    
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MeSH Terms
Cardiac Catheterization
Follow-Up Studies
Heart Valve Prosthesis Implantation / statistics & numerical data*,  trends
Middle Aged
Postoperative Complications / epidemiology,  ultrasonography
Pulmonary Valve / surgery*
Retrospective Studies
Surgical Procedures, Minimally Invasive / statistics & numerical data,  trends
Tetralogy of Fallot / complications,  surgery
Treatment Outcome
Ventricular Outflow Obstruction / etiology,  surgery*
Grant Support
FS/08/012/24454//British Heart Foundation; //British Heart Foundation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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