期刊
EUROPEAN HEART JOURNAL
卷 29, 期 6, 页码 810-815出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehn073
关键词
catheterization; percutaneous pulmonary valve; congenital heart disease
资金
- British Heart Foundation [rg/03/006] Funding Source: Medline
Aims Percutaneous pulmonary valve implantation (PPVI) is now an accepted treatment strategy for right ventricular (RV) outflow tract (RVOT) dysfunction in many European Heart Centres. We analysed the efficacy of repeat PPVI as a treatment modality for early device failure. Methods and results Twenty patients underwent repeat PPVI for RVOT obstruction because of early device failure ('Hammock effect', 'Hammock-like effect', stent fracture, residual stenosis). Repeat PPVI was feasible in all patients with no procedural complications. Following implantation of a second device, catheter-measured RVOT gradient and RV systolic pressure fell significantly (RVOT gradient: 46.1 +/- 3.9 to 18.1 +/- 2.4 mmHg, P < 0.001; RVSP: 70.9 +/- 4.8 to 46.1 +/- 2.6 mmHg, P < 0.001), in all but one patient (15 years, male, common arterial trunk, 11.5 mm homograft). During follow-up, four of 20 required re-intervention [third PPVI for stent fracture (n = 2), device explantation: external compression by the sternum (n = 1), endocarditis (n = 1)], and one of the 20 is awaiting surgical management. In the remainder, second PPVI resulted in a sustained improvement in haemodynamics with a mean follow-up of 10.9 +/- 3.0 months. In this series, the probability of freedom from re-intervention at 2 years was higher after second PPVI when compared with the index procedure (89.4 vs. 20.0%, P < 0.001). Conclusion Repeat PPVI is an effective treatment for early device failure in defined conditions and leads to improved freedom from re-intervention.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据