Document Detail

Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent.
MedLine Citation:
PMID:  20602475     Owner:  NLM     Status:  In-Data-Review    
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/m(2) ; P = 0.002 and 68.4 ± 41.5 vs. 50.9 ± 40.6 mL/m(2) ; 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. © 2010 Wiley-Liss, Inc.
Marcin Demkow; Elżbieta Katarzyna Biernacka; Mateusz Spiewak; Mirosław Kowalski; Hanna Siudalska; Piotr Wolski; Lars Sondergaard; Jolanta Miśko; Piotr Hoffman; Witold Rużyłło
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  77     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland; Cardiac Catheterization Laboratory, Institute of Cardiology, Warsaw, Poland.
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