Melody (R) transcatheter pulmonary valve implantation: Results from a French registry

作者:Fraisse Alain; Aldebert Philippe; Malekzadeh Milani Sophie; Thambo Jean Benoit; Piechaud Jean Francois; Aucoururier Pascaline; Chatelier Gilles; Bonnet Damien; Iserin Laurence; Bonello Beatrice; Assaidi Anass; Kammache Issam; Boudjemline Younes*
来源:Archives of Cardiovascular Diseases, 2014, 107(11): 607-614.
DOI:10.1016/j.acvd.2014.10.001

摘要

Background. - Percutaneous implantation of pulmonary valves has recently been introduced into clinical practice. %26lt;br%26gt;Aim. - To analyse data of patients treated in France between April 2008 and December 2010. %26lt;br%26gt;Methods. - Prospective, observational, multi-centric survey by means of a database registry of the Filiale de cardiologie pediatrique et congenitale. Results. Sixty-four patients were included, with a median (range) age of 21.4 (10.5-77.3) years. The majority (60.9%) of the patients were New York Heart Association (NYHA) class II. The most common congenital heart disease was tetralogy of Fallot with or without pulmonary atresia (50%). Indication for valve implantation was stenosis in 21.9%, regurgitation in 10.9% and association of stenosis and regurgitation in 67.2%. Implantation was successful in all patients. Pre-stenting was performed in 96.9% of cases. Median (range) procedure time was 92.5 (25-250) minutes. No significant regurgitation was recorded after the procedure, and the trans-pulmonary gradient was significantly reduced. Early minor complications occurred in five cases (7.8%). Three patients died during a median follow-up of 4.6 (0.2-5.2) years, two from infectious endocarditis and one from end-stage cardiac failure. Surgical reintervention was required in three patients. Follow-up with magnetic resonance imaging demonstrated significant improvements in right ventricular volumes and pulmonary regurgitation in mixed and regurgitant lesions. %26lt;br%26gt;Conclusions. - Transcatheter pulmonary valve implantation is highly feasible and mid-term follow-up demonstrates sustained improvement of right ventricular function. Late endocarditis is of concern, therefore longer follow-up in more patients is urgently needed to better assess long-term outcome.

  • 出版日期2014-11