JACC: Cardiovascular Interventions
Focus on Pulmonic and Aortic Valve Intervention
Branch Pulmonary Artery Valve Implantation Reduces Pulmonary Regurgitation and Improves Right Ventricular Size/Function in Patients With Large Right Ventricular Outflow Tracts
Athar M. Qureshi, Neha Bansal, Doff B. McElhinney, Younes Boudjemline, Tom J. Forbes, Nicola Maschietto, Shabana Shahanavaz, John P. Cheatham, Richard Krasuski, Luke Lamers, Massimo Chessa, Brian H. Morray, Bryan H. Goldstein, Cory V. Noel, Yunfei Wang and Matthew J. Gillespie
Table 1
Table 1
Demographic, Baseline Testing, and Procedural Data (N = 34)
| (n) | Median (Min, Max) | |
|---|---|---|
| Age, yrs | 34 | 26.2 (12.6, 58.0) |
| Weight, kg | 33 | 74.0 (26.0, 147) |
| Branch PA valve attempt (pts) | ||
| Bilateral branch PA | 18 (53) | |
| Unilateral branch PA | 16 (47) | |
| Diagnosis | ||
| ToF, PA/VSD | 32 (94) | |
| Truncus arteriosus | 1 (3) | |
| PA sarcoma (post-surgery) | 1 (3) | |
| High-risk surgery candidate | 21 (62) | |
| NYHA functional class | 34 | |
| I | 1 (3) | |
| II | 16 (47) | |
| III | 9 (26) | |
| IV | 8 (24) | |
| Echocardiography | 34 (100) | |
| Severe PR | 34 (100) | |
| RV size | ||
| Severe dilation | 23 (68) | |
| Moderate dilation | 7 (21) | |
| Mild dilation | 3 (9) | |
| Normal size | 1 (3) | |
| Cardiac MRI | ||
| RVEDVIx, ml/m2 | 28 | 149 (103, 478) |
| RVESVIx, ml/m2 | 22 | 90.5 (41, 387) |
| RVEF, % | 26 | 41 (18, 63) |
| LVEF, % | 25 | 54 (37, 65) |
| PR fraction, % | 26 | 47 (25, 66) |
| Cardiac catheterization | ||
| Cardiac index, (ml/min/m2) | 21 | 2.4 (1.5, 4.4) |
| RV pressure, mm Hg | 34 | 50.5 (20, 110) |
| Ao pressure, mm Hg | 34 | 98 (75, 127) |
| RVOT gradient, mm Hg | 34 | 0 (0, 20) |
| PA stenosis (valve implantations, n = 52) | 15 (29) | |
| Pre-stent (valve implantations, n = 52) | 47 (90) | |
| Success (patients) | 32 (94) | |
| Success (valve implantations, n = 52) | 50 (96) | |
| Valve implantation diameter, n = 50 | ||
| 18-mm Melody valve | 6 (12) | |
| 20-mm Melody valve | 7 (14) | |
| 22-mm Melody valve | 21 (42) | |
| 24-mm Melody valve | 10 (20) | |
| 26-mm Sapien valve | 3 (6) | |
| 29-mm Sapien valve | 3 (6) | |
Ao = aorta; LVEF = left ventricular ejection fraction; MRI = magnetic resonance imaging; NYHA = New York Heart Association; PA = pulmonary artery; PA/VSD = pulmonary atresia/ventricular septal defect; PR = pulmonary regurgitation; RV = right ventricle; RVEDVIx = right ventricular end-diastolic volume index; RVEF = right ventricular ejection fraction; RVESVIx = right ventricular end-systolic volume index; RVOT = right ventricular outflow tract; ToF = tetralogy of Fallot.
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