Transcatheter pulmonary valve implantation in patients with right ventricular outflow tract dysfunction: early and mid-term results.

Abstract

The aim of this study was to determine early and long-term results after transcatheter pulmonary valve implantation (TPVI) performed with the use of Medtronic Melody and Edwards Sapien valves in patients with full conduit or patched right ventricular outflow tract (RVOT) dysfunction. The study comprised 40 consecutive patients (full conduit, n = 25; RVOT patch, n = 15) who underwent TPVI between December 2008 and April 2012. TPVI was successfully performed in 37 patients (92.5%). The gradient across RVOT decreased from 82.96 ± 37.90 mm Hg to 34.33 ± 22.2 mm Hg on the day following TPVI (P<.001) and remained low at follow-up of 20.4 ± 11.4 months. The competency of the pulmonary valve was restored and maintained during the follow-up. New York Heart Association class, right ventricle end-diastolic volume, and right ventricular ejection fraction all improved as soon as 1 month after the procedure. Infective endocarditis was observed in 4 patients (1 died). Four patients underwent surgeries due to endocarditis, homograft rupture, stent migration, and early valve compression. TPVI may be performed safely and effectively in patients with right ventricle-pulmonary artery conduit and in selected patients with patched RVOT.