使用自膨胀的经皮肺动脉瓣系统经导管肺动脉瓣植入术：3年的CE研究结果。

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions Pub Date : 2025-04-28 DOI:10.1016/j.jcin.2024.12.031

Shakeel A. Qureshi MD , Matthew I. Jones MD , Kuberan Pushparajah MD , Jou-Kou Wang MD , Damien Kenny MD , Kevin Walsh MD , Younes Boudjemline MD , Worakan Promphan MD , Pimpak Prachasilchai MD , John Thomson MD , James R. Bentham MD , Felix Berger MD , Carlos A.C. Pedra MD , Marc Gewillig MD , Bryan P. Yan MD , Ziyad M. Hijazi MD

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引用次数: 0

摘要

背景：在法洛四联症和其他右心室流出道（RVOTs）手术修复后的随访中，肺反流是常见的。许多经皮肺瓣膜已被使用，但仅限于较小的rvot。目的：自2016年8月起，开展了一项多中心CE （conformit europ尘肺）研究，以评估自膨胀的venusp瓣膜。我们的目的是报告急性期和3年随访结果。方法：共招募81例肺返流患者行静脉瓣膜植入术，为期3年。结果：所有患者均成功植入静脉瓣膜。平均年龄26.5±13.3岁，平均体重59.5±15.6 kg。没有早期手术相关或晚期死亡。1例患者出现肺动脉分支导丝穿孔导致咯血，1例患者在手术结束时出现室性心动过速。在随访中，1例患者出现室性心动过速，在瓣膜植入5个月后需要植入心律转复除颤器并消融RVOT。一例在植入后11个月发生心内膜炎。经过医学治疗，瓣膜继续正常工作。1例患者在植入后3年远端出现血栓，并接受抗凝治疗。在3年的随访中，所有患者的瓣膜功能保持良好，右室重构发生。结论：我们报告了经皮肺动脉瓣植入术治疗严重肺反流患者3年的CE研究结果。该阀门已显示出良好的安全性和耐用性。长期评估是必要的。

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Transcatheter Pulmonary Valve Implantation Using Self-Expandable Percutaneous Pulmonary Valve System

Background

Pulmonary regurgitation is common during follow-up of patients after surgical repair of tetralogy of Fallot and other right ventricular outflow tracts (RVOTs). Many percutaneous pulmonary valves have been used but are limited to smaller RVOTs.

Objectives

Since August 2016, a multicenter CE (Conformité Européenne) study was initiated to evaluate a self-expandable VenusP-valve. We aimed to report the acute and 3-year follow-up results.

Methods

A total of 81 patients with pulmonary regurgitation were recruited for VenusP-valve implantation and assessed for a 3-year period.

Results

In all patients, VenusP-valves were successfully implanted. The mean age was 26.5 ± 13.3 years and the mean weight 59.5 ± 15.6 kg. There was no early procedure-related or late mortality. One patient experienced guidewire perforation of a branch pulmonary artery, causing hemoptysis, and 1 had ventricular tachycardia, at the end of the procedure. During follow-up, 1 patient developed runs of ventricular tachycardia and needed an implantable cardioverter-defibrillator and ablation of the RVOT 5 months after valve implantation. One developed endocarditis 11 months after implantation. After medical treatment, the valve has continued to function normally. One patient developed thrombus on the distal flare 3 years after implantation and was treated with anticoagulants. During 3-year follow-up, valve function has remained satisfactory and right ventricular remodeling has occurred in all patients.

Conclusions

We report the 3-year CE study results of percutaneous pulmonary valve implantation in patients with severe pulmonary regurgitation. The valve has shown promising safety and durability. Long-term evaluation is warranted.

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来源期刊

JACC. Cardiovascular interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

11.60

自引率

8.80%

发文量

756

审稿时长

4-8 weeks

期刊介绍： JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.