Long-term outcomes of transcatheter pulmonary valve implantation with melody and SAPIEN valves

被引:9
|
作者
Houeijeh, Ali [1 ,2 ]
Batteux, Clement [1 ]
Karsenty, Clement [1 ,3 ]
Ramdane, Nassima [2 ]
Lecerf, Florence [1 ,4 ]
Valdeolmillos, Estibaliz [1 ,4 ]
Lourtet-Hascoet, Julie [5 ]
Cohen, Sarah [1 ]
Belli, Emre [1 ]
Petit, Jerome [1 ]
Hascoet, Sebastien [1 ,4 ,6 ]
机构
[1] Univ Paris Saclay, Fac Med, Grp Hosp Paris St Joseph, Dept Congenital Heart Dis,Marie Lannelongue Hosp, 133 Ave Resistance, F-92350 Le Plessis Robinson, France
[2] Univ Lille II, Fac Med, Lab EA4489, Dept Congenital Heart Dis,Lille Univ Hosp, Lille, France
[3] CHU Toulouse, Hop Enfants, Serv Cardiol Pediat, 330 Ave Grande, Toulouse, Bretagne, France
[4] Univ Paris Saclay, Hop Marie Lannelongue, Fac Med, Inserm UMR S 999, 133 Ave Resistance, F-92350 Saclay, France
[5] Hop St Joseph, Serv Microbiol Clin, Grp Hosp Paris St Joseph, 185 Rue Raymond Losserand, Paris, France
[6] Hop Marie Lannelongue, 133 Ave Resistance, F-92350 Le Plessis Robinson, France
关键词
Pulmonary valve; Infective endocarditis; Melody; SAPIEN; Congenital heart disease; INFECTIVE ENDOCARDITIS; PERCUTANEOUS REPLACEMENT; HEART-VALVE; MULTICENTER; CONDUIT; RISK;
D O I
10.1016/j.ijcard.2022.10.141
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Transcatheter pulmonary valve implantation (TPVI) is effective for treating right ventricle outflow tract (RVOT) dysfunction. Factors associated with long-term valve durability remain to be investigated.Methods: Consecutive patients successfully treated by TPVI with Melody valves (n = 32) and SAPIEN valves (n = 182) between 2008 and 2020 at a single tertiary centre were included prospectively and monitored.Results: The 214 patients had a median age of 28 years (range, 10-81). The RVOT was a patched native pul-monary artery in 96 (44.8%) patients. Median follow-up was 2.8 years (range, 3 months-11.4 years). Secondary pulmonary valve replacement (sPVR) was performed in 23 cases (10.7%), due to stenosis (n = 22, 95.7%) or severe regurgitation (n = 1, 4.3%), yielding an incidence of 7.6/100 patient-years with melody valves and 1.3/ 100 patient-years with SAPIEN valves (P = 0.06). The 5-and 10-year sPVR-freedom rates were 78.1% and 50.4% with Melody vs. 94.3% and 82.2% with SAPIEN, respectively (P = 0.06). The incidence of infective endocarditis (IE) was 5.5/100 patient-years with Melody and 0.2/100 patient-years with SAPIEN (P < 0.0001). Factors associated with sPVR by univariate analysis were RV obstruction before TPVI (P = 0.04), transpulmonary maximal velocity > 2.7 m/s after TPVI (p = 0.0005), valve diameter <= 22 mm (P < 0.003), IE (P < 0.0001), and age < 25 years at TPVI (P = 0.04). By multivariate analysis adjusted for IE occurrence, transpulmonary maximal velocity remained associated with sPVR. Conclusions: TPVI is effective for treating RVOT dysfunction. Incidence of sPVR is higher in patients with residual RV obstruction or IE. IE add a substantial risk of TPVI graft failure and is mainly linked to the Melody valve. Social media abstract: Transcatheter pulmonary valve implantation is effective for treating right ventricular outflow tract dysfunction in patients with congenital heart diseases. Incidence of secondary valve replacement is higher in patients with residual obstruction or infective endocarditis.
引用
收藏
页码:156 / 166
页数:11
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