Belahnech Yassin, Martí-Aguasca Gerard, Dos-Subirà Laura, Betrian-Blasco Pedro, García Del Blanco Bruno, Calvo-Barceló Maria, Ródenas-Alesina Eduard, Pijuan-Domènech Antonia, Gran Ferran, Ferrer Queralt, Giralt-García Gemma, Miranda Berta, Gordon Blanca, González-Fernández Víctor, Barrabés José A, Roses-Noguer Ferran, Ferreira-González Ignacio
Cardiology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain.
Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain.
Sci Rep. 2025 Feb 1;15(1):3977. doi: 10.1038/s41598-024-82336-4.
Information on mid-term outcomes of percutaneous pulmonary valve replacement (PPVR) with the Edwards Sapien (ES) valve in the native right ventricular outflow tract (RVOT) are limited. This study assesses mid-term outcomes in 76 patients who underwent PPVR between 2016 and 2022, comparing native (40.8%) and non-native (59.2%) RVOTs. The primary endpoint was a composite of endocarditis, reinterventions, and cardiovascular death and secondary outcomes included prosthetic valve dysfunction (PVD), tricuspid regurgitation (TR), right ventricular ejection fraction (RVEF), and indexed ventricular volumes. The median patient age was 23.9 years. Pulmonary regurgitation was predominant in the native RVOT group (67.7%), while pulmonary stenosis or combined lesions were more common in the non-native group (90.9%). Procedural success was 98.7%. After a median follow-up of 3.3 years, there was no significant difference in freedom from the primary outcome between groups (87.1% native vs. 93.1% non-native, p = 0.875). Endocarditis and reinterventions occurred at 1.2 per 100 patient-years, and PVD at 3.19 per 100 patient-years, with no differences between groups. A 1-year reduction in ventricular volumes and TR was seen only in the non-native group, with no improvement in RVEF. Overall, PPVR with the ES valve demonstrates satisfactory mid-term outcomes in both native and non-native RVOTs.
关于在天然右心室流出道(RVOT)中使用爱德华兹Sapien(ES)瓣膜进行经皮肺动脉瓣置换术(PPVR)的中期结果的信息有限。本研究评估了2016年至2022年间接受PPVR的76例患者的中期结果,比较了天然RVOT(40.8%)和非天然RVOT(59.2%)。主要终点是心内膜炎、再次干预和心血管死亡的复合终点,次要结局包括人工瓣膜功能障碍(PVD)、三尖瓣反流(TR)、右心室射血分数(RVEF)和指数化心室容积。患者中位年龄为23.9岁。天然RVOT组中肺动脉反流占主导(67.7%),而非天然组中肺动脉狭窄或合并病变更为常见(90.9%)。手术成功率为98.7%。中位随访3.3年后,两组间主要结局的无事件生存率无显著差异(天然组为87.1%,非天然组为93.1%,p = 0.875)。心内膜炎和再次干预的发生率为每100患者年1.2次,PVD为每100患者年发生3.19次,两组间无差异。仅在非天然组中观察到心室容积和TR在1年内有所降低,RVEF无改善。总体而言,使用ES瓣膜进行PPVR在天然和非天然RVOT中均显示出令人满意的中期结果。