کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5992581 | 1578672 | 2009 | 5 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Effective transcatheter valve implantation after pulmonary homograft failure: A new perspective on the Ross operation Effective transcatheter valve implantation after pulmonary homograft failure: A new perspective on the Ross operation](/preview/png/5992581.png)
ObjectiveThe Ross procedure offers good autograft function and low reoperation rates for the neoaortic valve; however, the rate of conduit dysfunction in the right ventricular outflow tract remains a concern. This study assessed percutaneous pulmonary valve implantation in this setting.MethodsWe retrospectively analyzed outcomes of 12 patients (mean age 28 ± 5 years) referred for percutaneous pulmonary valve implantation to treat right ventricle-pulmonary artery conduit failure 11.1 ± 3.3 years after Ross procedure.ResultsPercutaneous pulmonary valve implantation was feasible in all 12 patients, with no procedural complications (procedure time 99 ± 16 minutes, fluoroscopy time 21 ± 6 minutes). Right ventricular outflow tract gradient during catheterization and pulmonary regurgitant fraction on magnetic resonance imaging fell after valve implantation (gradient 34 ± 6 to 14 ± 3 mm Hg, P < .01, regurgitant fraction 20% ± 6% to 2% ± 1%, P < .05). After restoration of right ventricular outflow tract function, indexed right ventricular end-diastolic volume decreased (91 ± 13 to 78 ± 12 mL · beatâ1 · mâ2, P < .01) and maximal cardiopulmonary exercise performance improved (peak oxygen consumption 25.4 ± 2.3 to 30.8 ± 3.0 mL · kgâ1 · minâ1, P < .01). During follow-up (18.8 ± 4.6 months), there was 1 device explantation (restenosis). The probabilities of freedom from right ventricular outflow tract reoperation were 100% at 1 year and 90% at 3 years.ConclusionsPercutaneous pulmonary valve implantation provides an effective transcatheter treatment strategy to prolong the lifespan of right ventricle-pulmonary artery conduits after the Ross procedure, reducing the reoperation burden on patients with aortic valve disease.
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 138, Issue 1, July 2009, Pages 84-88