• Catheter Cardiovasc Interv · Feb 2011

    Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent.

    • Marcin Demkow, Elżbieta Katarzyna Biernacka, Mateusz Spiewak, Mirosław Kowalski, Hanna Siudalska, Piotr Wolski, Lars Sondergaard, Jolanta Miśko, Piotr Hoffman, and Witold Rużyłło.
    • Department of Coronary Artery Disease and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland. mdemkow@ikard.pl
    • Catheter Cardiovasc Interv. 2011 Feb 15;77(3):381-9.

    ObjectivesTo evaluate the effectiveness and safety of percutaneous pulmonary valve implantation (PPVI) with routine prestenting with a bare metal stent (BMS).BackgroundPPVI 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.MethodsConsecutive 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.ResultsPPVI 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.ConclusionsPPVI with routine prestenting with BMS is a safe and effective method of treatment in patients with repaired CHD.Copyright © 2010 Wiley-Liss, Inc.

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