316 Percutaneous right outflow tract valve implantation: when should we pre-stent?
| Autor: | Georgia Brugada, Alain Fraisse, Issam Kammache, Younes Boudjemline, Laurence Iserin |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Bare-metal stent
medicine.medical_specialty Percutaneous business.industry medicine.medical_treatment Stent equipment and supplies Surgery medicine.anatomical_structure surgical procedures operative Pulmonary valve medicine Stent implantation Severe stenosis cardiovascular diseases Cardiology and Cardiovascular Medicine business Prospective cohort study Delay time |
| Zdroj: | Archives of Cardiovascular Diseases Supplements. (1):104 |
| ISSN: | 1878-6480 |
| DOI: | 10.1016/S1878-6480(11)70318-4 |
| Popis: | Introduction Percutaneous pulmonary valve insertion has been recently introduced in clinical setting. Patient selection is widely accepted. Initial results demonstrated early and differed stent fractures that make consider pre-stenting as a previous step for the procedure. To date, differed or intra-procedure pre-stenting are both accepted techniques. Patients and methods We reviewed patients included over the last 6 months in the prospective study (REVALV) for patients undergoing RVOT intervention for severe stenosis and/or insufficiency. Only valved stent group is analyzed here. All patients undergoing valved stent implantation are previously pre-stented with a bare metal stent according to present recommendations. Thirty-seven patients were included, distributed in two gropus according moment of pre-stenting: differed pre-stenting (bare metal stent implantation several days before valved stent implantation -20 patients-) and same procedure pre-stenting (bare metal stent implantation at the same procedure of valved stent implantation-17 patients-). For analytical purposes, we considered RVOT anatomy (homograft, synthetic tube, patch-extended RVOT or native outflow tract). Results Overall, no differences were found regarding mean procedure times (77,35 vs 96,88, p = NS) and time of hospitalization (2,95 vs 3,63, p = NS). Mean delay time from pre-stenting to valvulation was 196,5 + −68 days. Rv to Ao ratio improvement from basal to valvulation was significantly better in intra-procedure pre-stenting group (0,172 vs 0,373, p = 0,009). Concerning complications, bare metal stent mobilization happened just after implantation while trying to place valved stent delivery gain. Two pelvic hematomas were observed (one of each group). Conclusions Intra-procedure pre-stenting influences final result when considering RV-to-Ao ratio improvement, probably related to increase radial strength. The risk, however, remains higher as freshly implanted bare metal stent can mobilize, especially in native RVOT. Stratification of patient should be considered while choosing candidates for valved stent implantation. |
| Databáze: | OpenAIRE |
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