Five-year results from a prospective multicentre study of percutaneous pulmonary valve implantation demonstrate sustained removal of significant pulmonary regurgitation, improved right ventricular outflow tract obstruction and improved quality of life

EuroIntervention. 2017 Feb 20;12(14):1715-1723. doi: 10.4244/EIJ-D-16-00443.

Abstract

Aims: Percutaneous pulmonary valve implantation (PPVI) is used to treat patients with dysfunctional pulmonary valve conduits. Short- and longer-term results from multiple trials have outlined haemodynamic improvements. Our aim was to report the long-term results, including quality of life, from a multicentre trial in Europe and Canada.

Methods and results: From October 2007 to April 2009, 71 patients (24 female; median age 19.0 [IQR: 14.0 to 25.0] years) were enrolled in a prospective cohort study. PPVI was performed successfully in 63 patients. At five-year follow-up four patients had died. Moderate and severe pulmonary regurgitation were completely resolved in all except one patient, who needed re-PPVI. Outflow tract obstruction improved significantly from a mean pressure gradient of 37.7±12.1 mmHg before PPVI to 17.3±9.7 mmHg at five-year follow-up; however, 11 patients needed treatment for restenosis. The EQ-5D quality of life utility index and visual analogue scale scores were both significantly improved six months post PPVI and remained so at five years.

Conclusions: Five-year results following PPVI demonstrate resolved moderate or severe pulmonary regurgitation, improved right ventricular outflow tract obstruction, and improved quality of life.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Cardiac Catheterization / methods
  • Female
  • Heart Valve Prosthesis
  • Hemodynamics / physiology
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Pulmonary Valve Insufficiency / physiopathology
  • Pulmonary Valve Insufficiency / surgery*
  • Pulmonary Valve Stenosis / physiopathology
  • Pulmonary Valve Stenosis / surgery*
  • Quality of Life*
  • Treatment Outcome
  • Ventricular Function, Right / physiology*
  • Ventricular Outflow Obstruction / physiopathology
  • Ventricular Outflow Obstruction / surgery*
  • Young Adult