Key result
Percutaneous pulmonary valve implantation significantly reduced right ventricular systolic pressure from 63 to 45 mm Hg (P<0.001) and right ventricular outflow tract gradient.
Why the study?
Does percutaneous pulmonary valve implantation improve hemodynamics and avoid surgical revision in patients with right ventricular outflow tract dysfunction?
Cohort (n=155)
Does percutaneous pulmonary valve implantation improve hemodynamics and avoid surgical revision in patients with right ventricular outflow tract dysfunction?
Absolute Event Rate: 45% vs 63%
p-value: p=<0.001
Percutaneous pulmonary valve implantation effectively improves hemodynamics and delays the need for surgical right ventricular outflow tract revision.
May support percutaneous pulmonary valve implantation for hemodynamic relief in outflow tract dysfunction; leaves open durability and randomized confirmation.
BACKGROUND: Percutaneous pulmonary valve implantation was introduced in the year 2000 as a nonsurgical treatment for patients with right ventricular outflow tract dysfunction. METHODS AND RESULTS: Between September 2000 and February 2007, 155 patients with stenosis and/or regurgitation underwent percutaneous pulmonary valve implantation. This led to significant reduction in right ventricular systolic pressure (from 63+/-18 to 45+/-13 mm Hg, P<0.001) and right ventricular outflow tract gradient (from 37+/-20 to 17+/-10 mm Hg, P<0.001). Follow-up ranged from 0 to 83.7 months (median 28.4 months). Freedom from reoperation was 93% (+/-2%), 86% (+/-3%), 84% (+/-4%), and 70% (+/-13%) at 10, 30, 50, and 70 months, respectively. Freedom from transcatheter reintervention was 95% (+/-2%), 87% (+/-3%), 73% (+/-6%), and 73% (+/-6%) at 10, 30, 50, and 70 months, respectively. Survival at 83 months was 96.9%. On time-dependent analysis, the first series of 50 patients (log-rank test P<0.001) and patients with a residual gradient >25 mm Hg (log-rank test P=0.01) were associated with a higher risk of reoperations. CONCLUSIONS: Percutaneous pulmonary valve implantation resulted in the ability to avoid surgical right ventricular outflow tract revision in the majority of cases. This procedure might reduce the number of operations needed over the total lifetime of patients with right ventricle-to-pulmonary artery conduits.
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Lurz et al. (2008) conducted a cohort in Right ventricular outflow tract dysfunction (n=155). Percutaneous pulmonary valve implantation was evaluated on Right ventricular systolic pressure (mm Hg) (p=<0.001). Percutaneous pulmonary valve implantation significantly reduced right ventricular systolic pressure from 63 to 45 mm Hg (P<0.001) and right ventricular outflow tract gradient.
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