TY - JOUR

T1 - Five-year results from a prospective multicentre study of percutaneous pulmonary valve implantation demonstrate sustained removal of significant pulmonary regurgitation, improved right ventricular outflow tract obstruction and improved quality of life

AU - Hager, Alfred

AU - Schubert, Stephan

AU - Ewert, Peter

AU - Søndergaard, Lars

AU - Witsenburg, Maarten

AU - Guccione, Paolo

AU - Benson, Lee N

AU - Suárez de Lezo, José

AU - Lung, Te-Hsin

AU - Hess, John

AU - Eicken, Andreas

AU - Berger, Felix

PY - 2017/2/20

Y1 - 2017/2/20

N2 - AIMS: Percutaneous pulmonary valve implantation (PPVI) is used to treat patients with dysfunctional pulmonary valve conduits. Short- and longer-term results from multiple trials have outlined haemodynamic improvements. Our aim was to report the long-term results, including quality of life, from a multicentre trial in Europe and Canada.METHODS AND RESULTS: From October 2007 to April 2009, 71 patients (24 female; median age 19.0 [IQR: 14.0 to 25.0] years) were enrolled in a prospective cohort study. PPVI was performed successfully in 63 patients. At five-year follow-up four patients had died. Moderate and severe pulmonary regurgitation were completely resolved in all except one patient, who needed re-PPVI. Outflow tract obstruction improved significantly from a mean pressure gradient of 37.7±12.1 mmHg before PPVI to 17.3±9.7 mmHg at five-year follow-up; however, 11 patients needed treatment for restenosis. The EQ-5D quality of life utility index and visual analogue scale scores were both significantly improved six months post PPVI and remained so at five years.CONCLUSIONS: Five-year results following PPVI demonstrate resolved moderate or severe pulmonary regurgitation, improved right ventricular outflow tract obstruction, and improved quality of life.

AB - AIMS: Percutaneous pulmonary valve implantation (PPVI) is used to treat patients with dysfunctional pulmonary valve conduits. Short- and longer-term results from multiple trials have outlined haemodynamic improvements. Our aim was to report the long-term results, including quality of life, from a multicentre trial in Europe and Canada.METHODS AND RESULTS: From October 2007 to April 2009, 71 patients (24 female; median age 19.0 [IQR: 14.0 to 25.0] years) were enrolled in a prospective cohort study. PPVI was performed successfully in 63 patients. At five-year follow-up four patients had died. Moderate and severe pulmonary regurgitation were completely resolved in all except one patient, who needed re-PPVI. Outflow tract obstruction improved significantly from a mean pressure gradient of 37.7±12.1 mmHg before PPVI to 17.3±9.7 mmHg at five-year follow-up; however, 11 patients needed treatment for restenosis. The EQ-5D quality of life utility index and visual analogue scale scores were both significantly improved six months post PPVI and remained so at five years.CONCLUSIONS: Five-year results following PPVI demonstrate resolved moderate or severe pulmonary regurgitation, improved right ventricular outflow tract obstruction, and improved quality of life.

KW - Adolescent

KW - Adult

KW - Cardiac Catheterization/methods

KW - Female

KW - Heart Valve Prosthesis

KW - Hemodynamics/physiology

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Pulmonary Valve Insufficiency/physiopathology

KW - Pulmonary Valve Stenosis/physiopathology

KW - Quality of Life

KW - Treatment Outcome

KW - Ventricular Function, Right/physiology

KW - Ventricular Outflow Obstruction/physiopathology

KW - Young Adult

U2 - 10.4244/EIJ-D-16-00443

DO - 10.4244/EIJ-D-16-00443

M3 - Journal article

C2 - 28216473

VL - 12

SP - 1715

EP - 1723

JO - EuroIntervention

JF - EuroIntervention

SN - 1774-024X

IS - 14

ER -