Diana Salas-Mera, César Abelleira Pardeiro, Enrique José Balbacid Domingo, Adolfo Sobrino Baladrón, José Luis Zunzunegui Martínez, Fernando Sarnago Cebada, Federico Gutiérrez-Larraya Aguado
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引用次数: 0
Abstract
Introduction and objectives: Surgery for congenital heart defects with right ventricular outflow tract (RVOT) stenosis often results in significant pulmonary regurgitation, requiring pulmonary valve replacement in the long term. Despite the development of balloon-expandable prostheses, the native RVOT frequently dilates beyond the maximum diameters allowed for these valves. To allow percutaneous pulmonary valve implantation (PPVI) in these patients, clinical trials have been initiated with self-expanding prostheses, including the PULSTA valve. The aim of this study was to report the initial experience with this valve at three Spanish hospitals.
Methods: Descriptive study presenting the results of PPVI with the PULSTA prosthesis in patients with native RVOT and pulmonary regurgitation.
Results: We included 10 patients with a mean age of 15 ± 2.8 years. The implantation was successful in all patients, with no major complications occurring during the procedure. The mean length of follow-up was 18 [range, 2-35] months. In 8 patients, cardiac magnetic resonance was performed at 6 months, revealing a reduction in mean end-diastolic volume (131.7 ± 31.7 mL/m2 vs 100.3 ± 28.9 mL/m2) and end-systolic volume (68 ± 20.8 mL/m2 vs 57 ± 18.5 mL/m2).
Conclusions: The PULSTA prosthesis offers a safe, feasible, and effective alternative for PPVI in patients with native dilated RVOT. Due to the limited available follow-up data, further studies are needed to assess its long-term safety and durability.
前言和目的:先天性心脏缺陷合并右心室流出道狭窄的手术常导致明显的肺返流,长期需要肺动脉瓣置换术。尽管发展了球囊式可膨胀假体,但原生RVOT经常扩张超过这些瓣膜允许的最大直径。为了允许经皮肺动脉瓣植入术(PPVI)在这些患者中,临床试验已经开始使用自膨胀假体,包括PULSTA瓣膜。本研究的目的是报告在三家西班牙医院使用该瓣膜的初步经验。方法:描述性研究采用PPVI配合PULSTA假体治疗先天性RVOT合并肺返流患者的效果。结果:纳入10例患者,平均年龄15±2.8岁。所有患者的植入都很成功,在手术过程中没有发生重大并发症。平均随访时间18个月[范围,2-35个月]。8例患者在6个月时进行心脏磁共振检查,发现舒张末期平均容积(131.7±31.7 mL/m2 vs 100.3±28.9 mL/m2)和收缩末期平均容积(68±20.8 mL/m2 vs 57±18.5 mL/m2)减少。结论:PULSTA假体是一种安全、可行、有效的替代方案,可用于原发性扩张性RVOT患者的PPVI。由于可用的随访数据有限,需要进一步的研究来评估其长期安全性和耐久性。