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Percutaneous pulmonary valve replacement after different duration of free pulmonary regurgitation in a porcine model: Effects on the right ventricle.
MedLine Citation:
PMID:  22995417     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Free pulmonary regurgitation (PR) after surgical correction of Tetralogy of Fallot (ToF) with transannular patching can lead to irreversible right ventricular (RV) failure. However, the optimal timing of valve replacement is still debated. METHODS AND RESULTS: Thirty six pigs were included in the study. Twenty one pigs had a bare metal stent placed in the pulmonary annulus inducing free PR and 9 animals served as control. Six animals died prematurely due to procedural complications. The 21 animals were divided into 3 groups with differential duration of PR (1, 2, 3months, respectively) after which PPVR was performed. After 1month with competent valve the animals were euthanized. Cardiac magnetic resonance (CMR) and right heart catheterization were performed serially. Free PR led to severe dilation of the RV in all three groups compared to matched controls (p<0.001). Final RV volume after one month with competent pulmonary valve was modeled. Increase in RV volume from baseline to valve replacement (ΔRV) was the only predictor of RV recovery (p<0.001) and increases in ΔRV beyond 120mL/m2 were predictive of very low probability of recovery. A total of 5 animals did not recover. CONCLUSIONS: Recovery of right ventricular function after free PR by treatment with PPVR was successful in the majority of animals. Increases in RV volume during PR were the only predictor of non-recovery after PPVR and duration of PR did not in itself predict treatment success.
Authors:
Mads Ersboell; Niels Vejlstrup; Jens Christian Nilsson; Jesper Kjaergaard; Wendy Norman; Theis Lange; Andrew Taylor; Philipp Bonhoeffer; Lars Sondergaard
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-18
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
The Heart Centre, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: mads.ersboell@gmail.com.
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