Novel uses for implanted haemodynamic monitoring in adults with subaortic right ventricles.

Autor:	Marshall V WH; Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA william.marshall@osumc.edu.; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Mah ML; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., DeSalvo J; Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA., Rajpal S; Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Lastinger LT; Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Salavitabar A; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Armstrong AK; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Berman D; Heart Institute, Children's Hospital Los Angeles, Los Angeles, California, USA., Lampert B; Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA., Wright LK; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Hickey J; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Metzger R; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Nandi D; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Gajarski R; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA., Daniels CJ; Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.; The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA.
Jazyk:	angličtina
Zdroj:	Heart (British Cardiac Society) [Heart] 2024 Mar 12; Vol. 110 (7), pp. 491-499. Date of Electronic Publication: 2024 Mar 12.
DOI:	10.1136/heartjnl-2023-323206
Abstrakt:	Background: Pulmonary hypertension (PH) is a common complication in patients with complete dextro-transposition of the great arteries (TGA) after atrial switch (D-TGA/AS) and congenitally corrected TGA (ccTGA). In this population with subaortic right ventricles (sRVs), echocardiography is a poor screening tool for PH; implantable invasive haemodynamic monitoring (IHM) could be used for this purpose, but data are limited. The aim of this study is to report on novel uses of IHM in patients with sRV. Methods: This retrospective study describes the uses of IHM, impact of IHM on heart failure hospitalisation (HFH) and device-related complications in adults with sRV from a single centre (2015-2022). Results: IHM was placed in 18 patients with sRV (median age 43 (range 30-54) years, 8 female, 16 with D-TGA/AS, 2 with ccTGA); 16 had moderate or severe sRV systolic dysfunction, 13 had PH on catheterisation. IHM was used for (1) Medical therapy titration, (2) Medical management after ventricular assist device in patients with transplant-limiting PH and (3) Serial monitoring of pulmonary artery pressures without repeat catheterisations to help identify the optimal time for heart transplant referral. In follow-up (median 23 months), HFHs/year were similar to the year prior to IHM (median 0 (IQR 0-1.0) before vs 0 (0-0.8) after, p=0.984). Device migration occurred in one, without long-term sequelae. Conclusions: Uses of IHM in patients with sRV are described which may minimise the need for serial catheterisations in a population where PH is prevalent. HFHs were low overall but not impacted by IHM. One device-related complication occurred without long-term consequence. Competing Interests: Competing interests: AKA is a consultant/proctor with Abbott. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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