Abstract 16793: Percutaneous Pulmonary Valve Implantation — Two Centre Experience with > 100 Patients
Objective: Dysfunction of valved conduits in the right ventricular outflow tract (RVOT) limits durability and enforces repeated surgical interventions. We report on our combined two centre experience with percutaneous pulmonary valve implantation (PPVI) in 102 patients.
Methods and Results: 97 pts with RVOT conduit dysfunction and five pts with a stenosed biological RA-RV valve (median weight 63 kg, range 28–103kg, median age 22.0yrs, range 9.1–69.6yrs, diagnoses: TOF/PA 57, TAC 15, TGA 8, post Ross 8, other 14) were scheduled for PPVI since December 2006. PPVI was successfully performed in all patients (pre stenting 96/101). The median systolic RVOT gradient decreased from 37 mmHg, range 5 – 91 mmHg to 13 mmHg, range 0 – 73 mmHg (p < 0.001) and the ratio RVP/AoP decreased from 62%, range 31–132% to 36%, range 20 – 81% (p < 0.0001). The median enddiastolic RV-volume index (MRI) decreased from 105 ml/m2, range 56 – 227 ml/m2 to 90 ml/m2 (p < 0.0001). Pulmonary regurgitation was significantly reduced in all pts. One patient died due to coronary artery compression. There was one transient AV-block. During follow-up (median 357 days, range 1 – 973 days) one Melody valve had to be removed surgically 6 months after implantation due to bacterial endocarditis. In 8/102 pts a repeated dilatation of the valve was done due to a significant residual systolic pressure gradient, which resulted in a valve-in-valve procedure in four. The incidence of stent fractures was 6%.
Conclusions: This study shows that PPVI effectively improves the hemodynamics in a selected patient collective. Pre-stenting lowers the incidence of stent fractures. The rate of complications at short term follow-up is low. However, the intervention is technically challenging. Longer clinical follow-up is needed.
- © 2010 by American Heart Association, Inc.