Experiencia inicial con la prótesis PULSTA para el tracto de salida del ventrículo derecho nativo en tres centros españoles

  1. Diana Salas Mera 1
  2. César Abelleira Pardeiro 1
  3. Enrique José Balbacid Domingo 1
  4. Adolfo Sobrino Baladrón 2
  5. José Luis Zunzunegui Martínez 2
  6. Fernando Sarnago Cebada 3
  7. Federico Gutiérrez-Larraya Aguado 1
  1. 1 Servicio de Cardiología Pediátrica, Hospital Universitario La Paz, Madrid, España
  2. 2 Servicio de Cardiología Pediátrica, Hospital Universitario Gregorio Marañón, Madrid, España
  3. 3 Unidad de Cardiopatías Congénitas del Adulto, Hospital Universitario 12 de Octubre, Madrid, España
Revista:
REC: Interventional Cardiology

ISSN: 2604-7276 2604-7306

Ano de publicación: 2024

Volume: 6

Número: 2

Páxinas: 89-96

Tipo: Artigo

DOI: 10.24875/RECIC.M23000405 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: REC: Interventional Cardiology

Resumo

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.

Referencias bibliográficas

  • Smith CA, McCracken C, Thomas AS, et al. Long-term Outcomes of Tetralogy of Fallot:A Study From the Pediatric Cardiac Care Consortium. JAMA Cardiol. 2019;4:34-41.
  • Baumgartner H, De Backer J, Babu-Narayan SV, et al.;ESC Scientific Document Group. 2020 ESC Guidelines for the management of adult congenital heart disease. Eur Heart J. 2021;42:563-645.
  • Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease:A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139:e698-e800.
  • Cools B, Brown S, Budts W, et al. Up to 11 years of experience with the Melody valved stent in the right ventricular outflow tract. EuroIntervention. 2018;14:e988-e994.
  • McElhinney DB, Zhang Y, Levi DS, et al. Reintervention and Survival After Transcatheter Pulmonary Valve Replacement. J Am Coll Cardiol. 2022;79:18-32.
  • Lawley CM, Tanous D, O'Donnell C, et al. Ten Years of Percutaneous Pulmonary Valve Implantation in Australia and New Zealand. Heart Lung Circ. 2022;31:1649-1657.
  • Morgan G, Prachasilchai P, Promphan W, et al. Medium-term results of percutaneous pulmonary valve implantation using the Venus P-valve:international experience. EuroIntervention. 2019;14:1363-1370.
  • Giugno L, Faccini A, Carminati M. Percutaneous Pulmonary Valve Implantation. Korean Circ J. 2020;50:302-316.
  • Kim AY, Jung JW, Jung SY, et al. Early Outcomes of Percutaneous Pulmonary Valve Implantation with Pulsta and Melody Valves:The First Report from Korea. J Clin Med. 2020;9:2769.
  • Lee SY, Kim GB, Kim SH, et al. Mid-term outcomes of the Pulsta transcatheter pulmonary valve for the native right ventricular outflow tract. Catheter Cardiovasc Interv. 2021;98:E724-E732.
  • Odemis E, Yenidogan I, Kizilkaya MH. Early results of PULSTA transcatheter heart valve in patients with enlarged right ventricular outflow tract and severe pulmonary regurgitation due to transannular patch. Cardiol Young. 2022;16:1-9.
  • Bouzas B, Kilner PJ, Gatzoulis MA. Pulmonary regurgitation:not a benign lesion. Eur Heart J. 2005;26:433-439.
  • Ansari MM, Cardoso R, Garcia D, et al. Percutaneous Pulmonary Valve Implantation:Present Status and Evolving Future. J Am Coll Cardiol. 2015;66:2246-2255.
  • Sivakumar K, Sagar P, Qureshi S, et al. Outcomes of Venus P-valve for dysfunctional right ventricular outflow tracts from Indian Venus P-valve database. Ann Pediatr Cardiol. 2021;14:281-292.
  • Garay F, Pan X, Zhang YJ, Wang C, Springmuller D. Early experience with the Venus p- valve for percutaneous pulmonary valve implantation in native outflow tract. Neth Heart J. 2017;25:76-81.
  • Morgan G, Prachasilchai P, Promphan W, et al. Medium-term results of percutaneous pulmonary valve implantation using the Venus P-valve:international experience. EuroIntervention. 2019;14:1363-1370.