Document Detail


Percutaneous pulmonary valve implantation: initial experience.
MedLine Citation:
PMID:  21428139     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: Patients with congenital heart disease who undergo surgical implantation of a conduit between the right ventricle and the pulmonary artery (RV-PA conduit) may develop stenosis and/or insufficiency over time. These cases, which are associated with arrhythmias, RV dysfunction and sudden death, remain a challenge for surgical re-intervention, due to its complexity and associated morbidity and mortality. Percutaneous pulmonary valve implantation (PPVI) is therefore a valid alternative.
OBJECTIVE: To report our center's initial experience with PPVI.
METHODS: Prospective assessment of clinical, echocardiographic, magnetic resonance, hemodynamic and angiographic data from our series of PPVI.
RESULTS: Six patients in NYHA functional class +/- II underwent PPVI. All had significant conduit dysfunction and five had stenosis. The procedure consisted of implanting a bare metal stent to reduce the risk of fracture of the Melody valved stents (Medtronic) that were then successfully deployed in all. The immediate hemodynamic results showed a reduction in RV pressure (94 +/-27 to 44 +/- 7 mmHg), RV/LV pressure ratio (94 +/-27 to 44 +/- 7%) and conduit gradient (65 +/- 28 to 11 +/- 4 mmHg), and no insufficiency. The median duration of the procedure was 180 minutes, with no major complications. Patients were discharged a median of two days after the procedure. After a median follow-up of 7.8 months, patients are in functional class I (5) or II (1), with no evidence of conduit dysfunction on non-invasive assessment.
CONCLUSIONS: Our results are similar to the excellent results reported in larger series. PPVI is a valid therapeutic option in patients with conduit dysfunction.
Authors:
José Diogo Ferreira Martins; Peter Ewert; Lídia Sousa; Isabel Freitas; Conceição Trigo; Nuno Jalles; Pedro Matos; Ana Agapito; Rui Ferreira; Fatima Ferreira Pinto
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology     Volume:  29     ISSN:  0870-2551     ISO Abbreviation:  Rev Port Cardiol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-03-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710716     Medline TA:  Rev Port Cardiol     Country:  Portugal    
Other Details:
Languages:  eng; por     Pagination:  1839-46     Citation Subset:  IM    
Affiliation:
Servigos de Cardiologia e Cardiologia Pedidtrica, Hospital de Santa Marta, EPE, Lisboa, Portugal. jdferreiramartins@gmail.com
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