Abstract 9124: Cardiopulmonary Exercise Testing to Evaluate Consequences of Transcutaneous Pulmonary Valve Implantation.
Introduction: Transcutaneous pulmonary valve (TCPV) provides a new tool for improving conduit stenosis and regurgitation in patients with right ventricle to pulmonary artery conduit dysfunction. We assessed the hypothesis that there is an improvement in clinical and physiological parameters of cardiopulmonary exercise testing (CPET) after implantation of a TCPV.
Methods: Patients who underwent a TCPV placement between 2008 and 2010 (n=139) were investigated with a standardized CPET protocol before, at 6 months and 1 year following TCPV placement. CPET was performed on a mechanically braked cycle ergometer with respiratory gas exchange analysis. Work rate was increased with a ramp protocol. Assessment of pulmonary function testing was included. In order to exclude patients with a suboptimal effort, only patients with RER ≥1.05 or max HR >85% predicted were included in this analysis.
Results: Statistically significant improvements were observed in the maximum workload and the ratio of expired air to expired CO2 at anaerobic threshold (VE/VCO2 ratio) at 6 months and one year post-TCPV (table). No significant change in the peak VO2 or percentage predicted oxygen pulse was detected. The decrease in the VE/VCO2 ratio suggests an improvement in pulmonary blood flow distribution and ventilation/perfusion matching and the increase in peak work rate suggests an improvement in exercise capacity post TCPV.
Conclusions: In patients with right ventricle to pulmonary artery conduit dysfunction, TCPV is associated with improvements in exercise capacity and ventilation/perfusion matching during exercise.
- © 2010 by American Heart Association, Inc.