| Pre-stenting with a bare metal stent before percutaneous pulmonary valve implantation: acute and 1-year outcomes. | |
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MedLine Citation:
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PMID: 20965979 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: To determine the feasibility and safety of pre-stenting with a bare metal stent (BMS) before percutaneous pulmonary valve implantation (PPVI), and to analyse whether this approach improves haemodynamic outcomes and impacts on the incidence of PPVI stent fractures. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Tertiary paediatric and adult congenital heart cardiac centre. PATIENTS AND INTERVENTIONS: 108 consecutive patients with congenital heart disease underwent PPVI between September 2005 and June 2008 (54 with PPVI alone, 54 with BMS pre-stenting before PPVI). RESULTS: There were no significant differences in procedural complication rates. Acutely, there was no difference in haemodynamic outcomes. Serial echocardiography revealed that in the subgroups of 'moderate' (26-40 mm Hg) and 'severe' (>40 mm Hg) right ventricular outflow tract (RVOT) obstruction, patients with pre-stenting showed a tendency towards lower peak RVOT velocities compared to patients after PPVI alone (p=0.01 and p=0.045, respectively). The incidence of PPVI stent fractures was not statistically different between treatment groups at 1 year (PPVI 31% vs BMS+PPVI 18%; p=0.16). However, pre-stenting with BMS was associated with a lower risk of developing PPVI stent fractures (HR 0.35, 95% CI 0.14 to 0.87, p=0.024). The probability of freedom from serious adverse follow-up events (death, device explantation, repeat PPVI) was not statistically different at 1 year (PPVI 92% vs BMS+PPVI 94%; p=0.44). CONCLUSIONS: Pre-stenting with BMS before PPVI is a feasible and safe modification of the established implantation protocol. Pre-stenting is associated with a reduced risk of developing PPVI stent fractures. |
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Authors:
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Johannes Nordmeyer; Philipp Lurz; Sachin Khambadkone; Silvia Schievano; Alexander Jones; Doff B McElhinney; Andrew M Taylor; Philipp Bonhoeffer |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-21 |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 97 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 118-23 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Unit, UCL Institute of Child Health, London, UK. |
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Descriptor/Qualifier:
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| Grant Support | |
ID/Acronym/Agency:
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CI/05/010//British Heart Foundation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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