Key result
Transcatheter pulmonary valve implantation significantly reduced the maximal pulmonary gradient from 49.0 to 27.6 mm Hg and resulted in an 86% freedom from serious adverse events over a mean 5.5 years.
Why the study?
The study was conducted to evaluate the long-term results of transcatheter pulmonary valve implantation performed in a single center.
Observational (n=100)
No
Absolute Event Rate: 27.6% vs 49%
p-value: p=<0.0001
TPVI is a safe and effective long-term treatment for RVOT dysfunction in patients with repaired congenital heart defects, though infective endocarditis remains a significant late complication.
Supports TPVI durability in select patients; leaves open randomized trials versus surgery before practice change.
Introduction: Transcatheter pulmonary valve implantation (TPVI) is a non-surgical method of treatment for patients with right ventricular outflow tract (RVOT) dysfunction after surgical repair of congenital heart defects (CHD). Aim: To evaluate the long-term results of TPVI performed in a single center.Material and methods: Over 10 years, TPVI was performed in 100 patients (mean age: 26.4 ±8.1 years), using Melody Medtronic or Sapien Edwards valves. Results: uptake significantly improved in 1 year after TPVI. Freedom from reintervention was 100% in 1 year. Freedom from serious adverse events was 86% in mean 5.5 years of observation. The main reason for reintervention was infective endocarditis (IE) (1.6% patients/year). Increased risk of IE was associated with severe PS before valve implantation and the suboptimal result of TPVI. The incidence of IE seems to be lower in patients treated permanently with antiplatelet therapy (1.8% vs. 0.9% patients/year, NS). Conclusions: TPVI is a safe and effective method of treatment in patients with RVOT dysfunction after surgical correction of CHD. To achieve a good outcome, precise patient selection and rigorous IE prevention are necessary.
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Rużyłło et al. (2020) conducted an observational in Right ventricular outflow tract dysfunction after surgical repair of congenital heart defects (n=100). Transcatheter pulmonary valve implantation vs. Pre-procedural baseline was evaluated on Maximal pulmonary gradient (mm Hg) (p=<0.0001). Transcatheter pulmonary valve implantation significantly reduced the maximal pulmonary gradient from 49.0 to 27.6 mm Hg and resulted in an 86% freedom from serious adverse events over a mean 5.5 years.
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