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自膨式Pulsta瓣膜在中欧首次植入肺动脉位置:短期结果

First-in-Central-Europe implantation of the self-expandable Pulsta valve in the pulmonary position: Short-term results.

作者信息

Korabiewska-Pluta Sara, Michalak Krzysztof, Młodawska Joanna, Łubisz Monika, Brzezińska-Rajszys Grażyna, Koleśnik Adam, Carminati Mario, Moszura Tomasz

机构信息

Department of Cardiology, Polish-Mother's Memorial Hospital Research Institute, Łódź, Poland.

Cardiovascular Interventional Laboratory, The Children's Memorial Health Institute, Warszawa, Poland.

出版信息

Kardiol Pol. 2025;83(2):157-162. doi: 10.33963/v.phj.103312. Epub 2025 Jan 2.

Abstract

BACKGROUND

Tetralogy of Fallot after complete correction constantly presents potential challenges in pediatric cardiology. In particular, patients with pulmonary regurgitation require ongoing monitoring, reoperation, or catheter intervention during adolescence. The increasing demand for a wide spectrum of sizes and shapes of implantable prostheses led to the development of the self-expanding Pulsta® valve.

AIMS

In this study, we evaluated postprocedural outcomes, focusing on pulmonary valve functionality and right ventricular (RV) parameters, using advanced echocardiographic techniques.

METHODS

We reviewed five pediatric patients before and over a 6-month follow-up period after the procedure using three-dimensional echocardiography acquisition (3D transthoracic echocardiography), RV global longitudinal strain, and tissue Doppler imaging.

RESULTS

All procedures were successful, with good early effects and no complications. Postprocedural assessment of RV diameter and volume showed a statistically significant reduction, and this trend continued during the follow-up period. However, in this cohort, RV ejection fraction, which was initially within the normal range, showed a slight reduction immediately after the procedure, followed by a gradual return to normal values during the follow-up. Similar statistically significant results in RV strain values were observed.

CONCLUSION

In the study group, the Pulsta® valve provided good early-term effectiveness and feasibility without adverse events, and the overall mortality rate was 0%, highlighting the potential benefits of this intervention as measured by echocardiographic parameters.

摘要

背景

法洛四联症完全矫正后在小儿心脏病学中一直存在潜在挑战。特别是,患有肺动脉反流的患者在青春期需要持续监测、再次手术或导管介入治疗。对各种尺寸和形状的可植入假体需求的增加导致了自膨胀Pulsta®瓣膜的研发。

目的

在本研究中,我们使用先进的超声心动图技术评估术后结果,重点关注肺动脉瓣功能和右心室(RV)参数。

方法

我们使用三维超声心动图采集(三维经胸超声心动图)、RV整体纵向应变和组织多普勒成像,在术前及术后6个月的随访期内对5例儿科患者进行了评估。

结果

所有手术均成功,早期效果良好,无并发症。术后对RV直径和容积的评估显示有统计学意义的减小,且这一趋势在随访期内持续。然而,在该队列中,最初处于正常范围内的RV射血分数在术后立即略有降低,随后在随访期间逐渐恢复到正常值。在RV应变值方面也观察到了类似的具有统计学意义的结果。

结论

在研究组中,Pulsta®瓣膜在无不良事件的情况下提供了良好的早期有效性和可行性,总死亡率为0%,突出了通过超声心动图参数衡量的这种干预措施的潜在益处。

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