Key result
Pulmonary valve replacement significantly reduced mean indexed right ventricular end-diastolic volume from 161 ml/m2 to 120 ml/m2 (p<0.001) in adults with corrected tetralogy of Fallot.
Why the study?
To evaluate right ventricular reverse remodelling after pulmonary valve replacement using cardiac magnetic resonance imaging in adults with corrected tetralogy of Fallot and severe pulmonary insufficiency.
Does pulmonary valve replacement improve right ventricular reverse remodeling in adults with corrected tetralogy of Fallot and severe pulmonary insufficiency?
Population
10 adults with corrected tetralogy of Fallot and severe pulmonary insufficiency accepted for pulmonary valve replacement
Comparison
Preoperative vs postoperative pulmonary valve replacement evaluation
Design
Prospective cohort study
Follow-up
10 ± 5 months for cardiac magnetic resonance and mean of 37 ± 12 months for survival
Authors
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PVR associated with RV remodeling in TOF adults; leaves open need for RCTs to guide timing and outcomes.
Observational (n=10)
No
Does pulmonary valve replacement improve right ventricular reverse remodeling in adults with corrected tetralogy of Fallot and severe pulmonary insufficiency?
Absolute Event Rate: 120% vs 161%
p-value: p=<0.001
Pulmonary valve replacement in adults with corrected tetralogy of Fallot leads to significant early right ventricular reverse remodeling, even when preoperative RVEDVI exceeds 160 ml/m2.
Guné et al. (2019) conducted an observational in Corrected tetralogy of Fallot with severe pulmonary insufficiency (n=10). Pulmonary valve replacement vs. Preoperative baseline was evaluated on Mean indexed right ventricular end-diastolic volume (RVEDVI) (p=<0.001). Pulmonary valve replacement significantly reduced mean indexed right ventricular end-diastolic volume from 161 ml/m2 to 120 ml/m2 (p<0.001) in adults with corrected tetralogy of Fallot.
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