Percutaneous implantation of the Edwards SAPIEN?/sup> pulmonic valve: initial results in the first 22 patients
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- 作者：Nikolaus A. Haas (1)
Axel Moysich (1)
Ulrich Neudorf (2)
Hojjat Mortezaeian (3)
Mohamed Abdel-Wahab (4)
Heike Schneider (5)
Daniel De Wolf (6)
Jerome Petit (7)
Sreeram Narayanswami (8)
Kai Thorsten Laser (1)
Eugen Sandica (1) - 关键词：Percutaneous pulmonary valve implantation (PPVI) ; Edwards SAPIEN?pulmonic valve ; Congenital heart disease ; Pulmonary stenosis ; Pulmonary regurgitation
- 刊名：Clinical Research in Cardiology
- 出版年：2013
- 出版时间：February 2013
- 年：2013
- 卷：102
- 期：2
- 页码：119-128
- 全文大小：422KB
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Axel Moysich (1)
Ulrich Neudorf (2)
Hojjat Mortezaeian (3)
Mohamed Abdel-Wahab (4)
Heike Schneider (5)
Daniel De Wolf (6)
Jerome Petit (7)
Sreeram Narayanswami (8)
Kai Thorsten Laser (1)
Eugen Sandica (1)
1. Center for Congenital Heart Defects, Heart and Diabetes Centre NRW, Georgstrasse 11, 32545, Bad Oeynhausen, Germany
2. Department for Pediatric Cardiology, University of Essen, 45147, Essen, Germany
3. Department of Pediatric Cardiology, Rajaie Heart Center, Teheran, Republic of Iran
4. Department of Cardiology, Herzzentrum, Segeberger Kliniken, 23795, Bad Segeberg, Germany
5. Department of Pediatric Cardiology and Intensive Care, University of G?ttingen, 37075, G?ttingen, Germany
6. Department of Pediatric Cardiology, University of Gent, Ghent, Belgium
7. Marie Lannelongue Hospital, 92350, Le Plessis Robinson, Paris, France
8. Department of Pediatric Cardiology, University of Cologne, 50937, Cologne, Germany
文摘
Background Percutaneous pulmonary valve implantation (PPVI) was introduced in 2000 as an interventional procedure for the treatment of right ventricular outflow tract (RVOT) dysfunction. The new Edwards SAPIEN?/sup> pulmonic valve has reached CE certification at the end of 2010 thus offering an attractive alternative with extended sizes (23 and 26?mm) to the conventional Melody? valve (sizes 18, 20 and 22?mm). Patients Over a 1-year period, PPVI using the Edwards SAPIEN?/sup> pulmonic valve was performed in 22 patients using a standardized procedure. Primary diagnosis was tetralogy of Fallot (n?=?11), pulmonary atresia (n?=?2), Truncus arteriosus (n?=?3), TGA/PS-Rastelli (n?=?1), Ross surgery (n?=?2), double outlet right ventricle (n?=?2) and absent pulmonary valve syndrome (n?=?1). The character of the RVOT for PPVI was transannular patch (n?=?4), bioprosthesis (n?=?2), homograft (n?=?5) and Contegra? conduit (n?=?11). The leading hemodynamic problem consisted of a pulmonary stenosis (PS) (n?=?2), pulmonary regurgitation (PR) (n?=?11) and a combined PS/PR lesion (n?=?9). Results In 21/22 patients, PPVI was performed successfully (10?×?23 and 11?×?26?mm). There were 9 female and 13 male patients; the mean age was 21.7?years (range 6-3?years), the mean length was 162?cm (range 111-81?cm) and the weight 56.5?kg (range 20-1?kg). Invasive data showed a decrease of RV-systolic pressure from 61.2?mmHg (±23.1) to 41.2?mmHg (±8.6) and reduction of RV–PA gradient from 37.3?mmHg (±23.2) to 6.9?mmHg (±5.3). The PA-systolic pressure increased from 25.8?mmHg (±8.6) to 33.9?mmHg (±9.3) as did the PA diastolic pressure (from 6.0?mmHg (±5.6) to 14.6?mmHg (±4.3). There was a substantial reduction of pulmonary regurgitation from before (none/trivial n?=?0, mild n?=?2, mode rate n?=?9, severe n?=?11) to after PPVI (none/trivial n?=?20, mild n?=?1). During the short-term follow-up of 5.7?months there was no change in the immediate results. Conclusion PPVI using the Edwards SAPIEN?/sup> pulmonic valve can be performed safely in a wide range of patients with various diagnoses and underlying pathology of the RVOT and enables the restoration of an adult-size RVOT diameter. Although the immediate and short-term results seem promising, the long-term effects and safety have to be assessed in further clinical follow-up studies.