Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation
| Autor: | Alfred Hager, Andreas Kühn, Andreas Eicken, Jelena Pabst von Ohain, Doff B. McElhinney, Daniel Tanase, Christian Meierhofer, Stanimir Georgiev, Peter Ewert |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Cardiac Catheterization Time Factors Ventricular Dysfunction Right Volume overload Hemodynamics 030204 cardiovascular system & hematology Severity of Illness Index 0302 clinical medicine Risk Factors Pulmonary Valve Replacement 030212 general & internal medicine Child Heart Valve Prosthesis Implantation Exercise Tolerance Ventricular Remodeling Tricuspid Valve Insufficiency Pulmonary Valve Stenosis Treatment Outcome medicine.anatomical_structure Echocardiography Cardiology Female Cardiology and Cardiovascular Medicine Artery Adult medicine.medical_specialty Adolescent Magnetic Resonance Imaging Cine Regurgitation (circulation) Ventricular Outflow Obstruction Young Adult 03 medical and health sciences Internal medicine medicine Humans Cardiac Surgical Procedures Ventricular remodeling Pulmonary Valve business.industry Recovery of Function medicine.disease Pulmonary Valve Insufficiency Surgery Stenosis Ventricle Case-Control Studies Exercise Test Ventricular Function Right business |
| Zdroj: | JACC: Cardiovascular Interventions. 10:701-708 |
| ISSN: | 1936-8798 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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