Key result
Percutaneous pulmonary valve implantation significantly reduced the right ventricular end-diastolic area from 15.15 to 11.60 cm² (P<0.0001) and decreased the RVOT gradient.
Why the study?
Right ventricular outflow tract dysfunction is common in adults with congenital heart abnormalities and requires multiple interventions; the effects and predictors of percutaneous pulmonary valve implantation outcomes need evaluation.
Does percutaneous pulmonary valve implantation induce right ventricular reverse remodeling in patients with right ventricular outflow tract dysfunction from congenital heart disease?
Observational (n=25)
No
Does percutaneous pulmonary valve implantation induce right ventricular reverse remodeling in patients with right ventricular outflow tract dysfunction from congenital heart disease?
Standardized Mean Difference: -1.21
Absolute Event Rate: 11.6% vs 15.15%
p-value: p=<0.0001
Percutaneous pulmonary valve implantation is effective for improving right ventricular remodeling and reducing outflow tract gradients in patients with congenital right heart abnormalities.
PPVI was associated with RV reverse remodeling in this small cohort; leaves open whether it improves hard outcomes in congenital RVOT dysfunction.
Background: Significant advancements in the surgical care of complicated congenital heart abnormalities have resulted in over 85% of individuals now attaining adulthood. Dysfunction of the right ventricular outflow system is a prevalent manifestation in these people and necessitates many surgical interventions during their lifetime. Percutaneous pulmonary valve implantation is an innovative procedure for addressing right ventricular outflow tract insufficiency. Aim: To evaluate the short- and long-term effects of percutaneous pulmonary valve implantation, as well as to identify factors that may indicate the likelihood of right ventricle reversal remodeling soon after the procedure. Subjects and methods: This retrospective, single-center observational study was conducted on 25 patients; one patient was transformed to surgery, and another patient died shortly after the procedure, so follow-up analysis was done on 23 patients. This study was done at Aswan Heart Centre, Aswan, Egypt, between August 2023 and September 2025. Results: The end diastolic area of the right ventricle shrank from (15.15 ± 4.16 cm² to 11.60 ± 2.51 cm² (p <0.0001, Cohen's d = -1.21). The end systolic area of the right ventricle shrank from 10.48 ± 3.44 cm² to 8.37 ± 2.61 cm² (p= 0.0014, Cohen’s d= -0.76). The RVOT gradient dropped dramatically, going from 51.43±31.52 to 23.29±12.16 mmHg (p<0.0001), and the degree of pulmonary regurgitation improved. Conclusion: Percutaneous pulmonary valve implantation has a good safety and efficacy profile with a very low incidence of adverse events.
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Mahmoud et al. (2026) conducted an observational in Right ventricular outflow tract insufficiency (n=25). Percutaneous pulmonary valve implantation vs. Baseline (pre-procedure) was evaluated on Right ventricular end diastolic area (cm²) (Cohen's d -1.21, p=<0.0001). Percutaneous pulmonary valve implantation significantly reduced the right ventricular end-diastolic area from 15.15 to 11.60 cm² (P<0.0001) and decreased the RVOT gradient.
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