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Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent.
Catheter Cardiovasc Interv. 2011 Feb 15; 77(3):381-9.CC

Abstract

OBJECTIVES

To evaluate the effectiveness and safety of percutaneous pulmonary valve implantation (PPVI) with routine prestenting with a bare metal stent (BMS).

BACKGROUND

PPVI is a relatively new method of treating patients with repaired congenital heart disease (CHD). Results of PPVI performed with routine prestenting have never been reported.

METHODS

Consecutive patients who underwent PPVI for homograft dysfunction with prestenting with BMS were studied. The schedule of follow-up assessment comprised clinical evaluation, cardiovascular magnetic resonance, transthoracic echocardiography, and chest X-ray to screen for device integrity.

RESULTS

PPVI was performed with no serious complications in all patients (n=10, mean age 26.8±4.0 years, 60% males). In nine patients with significant pulmonary stenosis, peak right ventricular outflow tract (RVOT) gradient was reduced from a mean of 80.6±22.7 to 38.8±10.4 mm Hg on the day following implantation (P=0.001). At 1-month and 6-month follow-ups, mean RVOT gradient was 34.0±9.8 and 32.0±12.2 mm Hg, respectively. In patients with significant pulmonary regurgitation, mean pulmonary regurgitation fraction decreased from 19%±6% to 2%±1% (P=0.0008). Relief of RVOT obstruction and restoration of pulmonary valve competence were associated with significant decrease in right ventricular (RV) end-diastolic and end-systolic volumes (125.5±48.6 to 109.2±42.9 mL/m2 ; P=0.002 and 68.4±41.5 vs. 50.9±40.6 mL/m2; P=0.001) as well as improvement in RV ejection fraction (48.8%±13.1% to 57.6%±14.4%; P=0.003) and New York Heart Association class (P=0.003). All patients completed 6-month follow-up. No stent fractures were observed.

CONCLUSIONS

PPVI with routine prestenting with BMS is a safe and effective method of treatment in patients with repaired CHD.

Authors+Show Affiliations

Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland. mdemkow@ikard.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20602475

Citation

Demkow, Marcin, et al. "Percutaneous Pulmonary Valve Implantation Preceded By Routine Prestenting With a Bare Metal Stent." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 77, no. 3, 2011, pp. 381-9.
Demkow M, Biernacka EK, Spiewak M, et al. Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent. Catheter Cardiovasc Interv. 2011;77(3):381-9.
Demkow, M., Biernacka, E. K., Spiewak, M., Kowalski, M., Siudalska, H., Wolski, P., Sondergaard, L., Miśko, J., Hoffman, P., & Rużyłło, W. (2011). Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 77(3), 381-9. https://doi.org/10.1002/ccd.22700
Demkow M, et al. Percutaneous Pulmonary Valve Implantation Preceded By Routine Prestenting With a Bare Metal Stent. Catheter Cardiovasc Interv. 2011 Feb 15;77(3):381-9. PubMed PMID: 20602475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent. AU - Demkow,Marcin, AU - Biernacka,Elżbieta Katarzyna, AU - Spiewak,Mateusz, AU - Kowalski,Mirosław, AU - Siudalska,Hanna, AU - Wolski,Piotr, AU - Sondergaard,Lars, AU - Miśko,Jolanta, AU - Hoffman,Piotr, AU - Rużyłło,Witold, PY - 2010/7/6/entrez PY - 2010/7/6/pubmed PY - 2011/6/8/medline SP - 381 EP - 9 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 77 IS - 3 N2 - OBJECTIVES: To evaluate the effectiveness and safety of percutaneous pulmonary valve implantation (PPVI) with routine prestenting with a bare metal stent (BMS). BACKGROUND: PPVI is a relatively new method of treating patients with repaired congenital heart disease (CHD). Results of PPVI performed with routine prestenting have never been reported. METHODS: Consecutive patients who underwent PPVI for homograft dysfunction with prestenting with BMS were studied. The schedule of follow-up assessment comprised clinical evaluation, cardiovascular magnetic resonance, transthoracic echocardiography, and chest X-ray to screen for device integrity. RESULTS: PPVI was performed with no serious complications in all patients (n=10, mean age 26.8±4.0 years, 60% males). In nine patients with significant pulmonary stenosis, peak right ventricular outflow tract (RVOT) gradient was reduced from a mean of 80.6±22.7 to 38.8±10.4 mm Hg on the day following implantation (P=0.001). At 1-month and 6-month follow-ups, mean RVOT gradient was 34.0±9.8 and 32.0±12.2 mm Hg, respectively. In patients with significant pulmonary regurgitation, mean pulmonary regurgitation fraction decreased from 19%±6% to 2%±1% (P=0.0008). Relief of RVOT obstruction and restoration of pulmonary valve competence were associated with significant decrease in right ventricular (RV) end-diastolic and end-systolic volumes (125.5±48.6 to 109.2±42.9 mL/m2 ; P=0.002 and 68.4±41.5 vs. 50.9±40.6 mL/m2; P=0.001) as well as improvement in RV ejection fraction (48.8%±13.1% to 57.6%±14.4%; P=0.003) and New York Heart Association class (P=0.003). All patients completed 6-month follow-up. No stent fractures were observed. CONCLUSIONS: PPVI with routine prestenting with BMS is a safe and effective method of treatment in patients with repaired CHD. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/20602475/Percutaneous_pulmonary_valve_implantation_preceded_by_routine_prestenting_with_a_bare_metal_stent_ DB - PRIME DP - Unbound Medicine ER -