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Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation.
JACC Cardiovasc Interv. 2017 04 10; 10(7):701-708.JC

Abstract

OBJECTIVES

This study sought to investigate the impact of tricuspid regurgitation (TR) on right ventricular function after percutaneous pulmonary valve implantation (PPVI).

BACKGROUND

PPVI provides a less invasive alternative to surgery in patients with right ventricular-to-pulmonary artery (RV-PA) conduit dysfunction. Recovery of the right ventricle has been described after PPVI for patients with pulmonary stenosis and for those with pulmonary regurgitation. Additional TR enforces RV dysfunction by supplemental volume overload. Limited data are available on the potential of the right ventricle to recover in such a specific hemodynamic situation.

METHODS

In a matched cohort study, we compared patients who underwent PPVI with additional TR with those without TR.

RESULTS

The degree of TR improved in 83% of the patients. In our patients (n = 36) exercise capacity and right ventricular volume index improved similarly 6 months after PPVI in patients with and without important TR. None of them had significant TR in the long-term follow-up of median 78 months.

CONCLUSIONS

PPVI improves not only RV-PA-conduit dysfunction, but also concomitant TR. In patients with a dysfunctional RV-PA conduit and TR, the decision whether to fix TR should be postponed after PPVI.

Authors+Show Affiliations

Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany. Electronic address: tanase@dhm.mhn.de.Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.Department of Cardiovascular Surgery, German Heart Centre of the Technical University Munich, Munich, Germany.Lucille Packard Children's Hospital Stanford, Palo Alto, California.Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28385408

Citation

Tanase, Daniel, et al. "Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation." JACC. Cardiovascular Interventions, vol. 10, no. 7, 2017, pp. 701-708.
Tanase D, Ewert P, Georgiev S, et al. Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation. JACC Cardiovasc Interv. 2017;10(7):701-708.
Tanase, D., Ewert, P., Georgiev, S., Meierhofer, C., Pabst von Ohain, J., McElhinney, D. B., Hager, A., Kühn, A., & Eicken, A. (2017). Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation. JACC. Cardiovascular Interventions, 10(7), 701-708. https://doi.org/10.1016/j.jcin.2017.01.036
Tanase D, et al. Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation. JACC Cardiovasc Interv. 2017 04 10;10(7):701-708. PubMed PMID: 28385408.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation. AU - Tanase,Daniel, AU - Ewert,Peter, AU - Georgiev,Stanimir, AU - Meierhofer,Christian, AU - Pabst von Ohain,Jelena, AU - McElhinney,Doff B, AU - Hager,Alfred, AU - Kühn,Andreas, AU - Eicken,Andreas, PY - 2016/09/20/received PY - 2017/01/19/revised PY - 2017/01/27/accepted PY - 2017/4/8/entrez PY - 2017/4/8/pubmed PY - 2017/9/26/medline KW - PPVI KW - RVEDVi KW - pulmonary valve replacement KW - tricuspid regurgitation SP - 701 EP - 708 JF - JACC. Cardiovascular interventions JO - JACC Cardiovasc Interv VL - 10 IS - 7 N2 - OBJECTIVES: This study sought to investigate the impact of tricuspid regurgitation (TR) on right ventricular function after percutaneous pulmonary valve implantation (PPVI). BACKGROUND: PPVI provides a less invasive alternative to surgery in patients with right ventricular-to-pulmonary artery (RV-PA) conduit dysfunction. Recovery of the right ventricle has been described after PPVI for patients with pulmonary stenosis and for those with pulmonary regurgitation. Additional TR enforces RV dysfunction by supplemental volume overload. Limited data are available on the potential of the right ventricle to recover in such a specific hemodynamic situation. METHODS: In a matched cohort study, we compared patients who underwent PPVI with additional TR with those without TR. RESULTS: The degree of TR improved in 83% of the patients. In our patients (n = 36) exercise capacity and right ventricular volume index improved similarly 6 months after PPVI in patients with and without important TR. None of them had significant TR in the long-term follow-up of median 78 months. CONCLUSIONS: PPVI improves not only RV-PA-conduit dysfunction, but also concomitant TR. In patients with a dysfunctional RV-PA conduit and TR, the decision whether to fix TR should be postponed after PPVI. SN - 1876-7605 UR - https://www.unboundmedicine.com/medline/citation/28385408/Tricuspid_Regurgitation_Does_Not_Impact_Right_Ventricular_Remodeling_After_Percutaneous_Pulmonary_Valve_Implantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1936-8798(17)30228-5 DB - PRIME DP - Unbound Medicine ER -