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RV to PA conduits: impact of transcatheter pulmonary valve replacement in adults - a national register study.
Scand Cardiovasc J. 2017 Jun; 51(3):153-158.SC

Abstract

OBJECTIVE

The use of a conduit is an established surgical method for reconstruction of the right ventricular outflow tract in congenital heart disease; however, its limited durability makes reintervention almost inevitable. We studied the trends in new implantation, reoperation, and transcatheter pulmonary valve replacement (TPVR) from a Swedish national perspective.

DESIGN AND RESULTS

The Swedish registry of congenital heart disease (SWEDCON) was used to collect data. From 2000-2014, there was an increase in adult patients with conduits from 122 to 536. There were 60 surgical conduit replacements, 40 TPVRs and 176 new conduit implantations in the study period. Perioperative mortality was <1%. The yearly number of new implantations and reoperations both doubled over the study period. Patients with new implantations were older (mean age, 36 years) compared with the reoperation and TPVR groups (mean age, 26 years) with the majority of patients having tetralogy of Fallot. The majority of conduit reinterventions were surgical also after the introduction of TPVR in 2007, with no significant difference regarding diagnosis, gender, age, or previous number or longevity of conduits.

CONCLUSION

The number of adults with conduits increased steadily with most conduit-related operations being new implantations in patients with tetralogy of Fallot. Surgical conduit replacements increased significantly and represented the majority of conduit reinterventions after the introduction of TPVR, indicating that TPVR is not used for the majority of patients with conduit failure. Diagnosis, gender, age, or previous number or longevity of conduits had no impact on choosing surgical replacement vs. TPVR.

Authors+Show Affiliations

a Department of Molecular and Clinical Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital , Gothenburg , Sweden.a Department of Molecular and Clinical Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital , Gothenburg , Sweden.b Department of Cardiology , Lund University and Skåne University Hospital , Lund , Sweden.a Department of Molecular and Clinical Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital , Gothenburg , Sweden.a Department of Molecular and Clinical Medicine , Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital , Gothenburg , Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28276717

Citation

Skoglund, Kristofer, et al. "RV to PA Conduits: Impact of Transcatheter Pulmonary Valve Replacement in Adults - a National Register Study." Scandinavian Cardiovascular Journal : SCJ, vol. 51, no. 3, 2017, pp. 153-158.
Skoglund K, Svensson G, Thilén U, et al. RV to PA conduits: impact of transcatheter pulmonary valve replacement in adults - a national register study. Scand Cardiovasc J. 2017;51(3):153-158.
Skoglund, K., Svensson, G., Thilén, U., Dellborg, M., & Eriksson, P. (2017). RV to PA conduits: impact of transcatheter pulmonary valve replacement in adults - a national register study. Scandinavian Cardiovascular Journal : SCJ, 51(3), 153-158. https://doi.org/10.1080/14017431.2017.1291988
Skoglund K, et al. RV to PA Conduits: Impact of Transcatheter Pulmonary Valve Replacement in Adults - a National Register Study. Scand Cardiovasc J. 2017;51(3):153-158. PubMed PMID: 28276717.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - RV to PA conduits: impact of transcatheter pulmonary valve replacement in adults - a national register study. AU - Skoglund,Kristofer, AU - Svensson,Gunnar, AU - Thilén,Ulf, AU - Dellborg,Mikael, AU - Eriksson,Peter, Y1 - 2017/02/15/ PY - 2017/3/10/pubmed PY - 2017/8/2/medline PY - 2017/3/10/entrez KW - Congenital heart disease KW - conduit KW - pulmonary valve KW - transcatheter pulmonary valve replacement SP - 153 EP - 158 JF - Scandinavian cardiovascular journal : SCJ JO - Scand Cardiovasc J VL - 51 IS - 3 N2 - OBJECTIVE: The use of a conduit is an established surgical method for reconstruction of the right ventricular outflow tract in congenital heart disease; however, its limited durability makes reintervention almost inevitable. We studied the trends in new implantation, reoperation, and transcatheter pulmonary valve replacement (TPVR) from a Swedish national perspective. DESIGN AND RESULTS: The Swedish registry of congenital heart disease (SWEDCON) was used to collect data. From 2000-2014, there was an increase in adult patients with conduits from 122 to 536. There were 60 surgical conduit replacements, 40 TPVRs and 176 new conduit implantations in the study period. Perioperative mortality was <1%. The yearly number of new implantations and reoperations both doubled over the study period. Patients with new implantations were older (mean age, 36 years) compared with the reoperation and TPVR groups (mean age, 26 years) with the majority of patients having tetralogy of Fallot. The majority of conduit reinterventions were surgical also after the introduction of TPVR in 2007, with no significant difference regarding diagnosis, gender, age, or previous number or longevity of conduits. CONCLUSION: The number of adults with conduits increased steadily with most conduit-related operations being new implantations in patients with tetralogy of Fallot. Surgical conduit replacements increased significantly and represented the majority of conduit reinterventions after the introduction of TPVR, indicating that TPVR is not used for the majority of patients with conduit failure. Diagnosis, gender, age, or previous number or longevity of conduits had no impact on choosing surgical replacement vs. TPVR. SN - 1651-2006 UR - https://www.unboundmedicine.com/medline/citation/28276717/RV_to_PA_conduits:_impact_of_transcatheter_pulmonary_valve_replacement_in_adults___a_national_register_study_ L2 - https://www.tandfonline.com/doi/full/10.1080/14017431.2017.1291988 DB - PRIME DP - Unbound Medicine ER -