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Pulmonary Valve Replacement in Tetralogy of Fallot: Procedural Volume and Durability of Bioprosthetic Pulmonary Valves.
Gröning, Mathis; Smerup, Morten Holdgaard; Munk, Kim; Andersen, Helle; Nielsen, Dorte Guldbrand; Nissen, Henrik; Mortensen, Ulrik Markus; Jensen, Annette Schophuus; Bække, Pernille Steen; Bjerre, Jesper; Engholm, Morten; Vejlstrup, Niels; Juul, Klaus; Søndergaard, Eva Vad; Thyregod, Hans Gustav Hørsted; Andersen, Henrik Ørbæk; Helvind, Morten; De Backer, Ole; Jøns, Christian; Schmidt, Michael Rahbek; Jørgensen, Troels Højsgaard; Sondergaard, Lars.
Afiliación
  • Gröning M; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark. Electronic address: mathis.groening@regionh.dk.
  • Smerup MH; Department of Cardio-Thoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Munk K; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Andersen H; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
  • Nielsen DG; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Nissen H; Department of Cardiology, Odense University Hospital, Odense, Denmark.
  • Mortensen UM; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Jensen AS; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Bække PS; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Bjerre J; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
  • Engholm M; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
  • Vejlstrup N; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Juul K; Department of Pediatrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Søndergaard EV; Department of Cardiology, Odense University Hospital, Odense, Denmark.
  • Thyregod HGH; Department of Cardio-Thoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Andersen HØ; Department of Cardio-Thoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Helvind M; Department of Cardio-Thoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • De Backer O; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Jøns C; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Schmidt MR; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Jørgensen TH; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Sondergaard L; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
JACC Cardiovasc Interv ; 17(2): 217-227, 2024 Jan 22.
Article en En | MEDLINE | ID: mdl-38127022
ABSTRACT

BACKGROUND:

Robust data on changes in pulmonary valve replacement (PVR) procedural volume and predictors of bioprosthetic pulmonary valve (BPV) durability in patients with tetralogy of Fallot (TOF) are scarce.

OBJECTIVES:

This study sought to assess temporal trends in PVR procedural volume and BPV durability in a nationwide, retrospective TOF cohort.

METHODS:

Data were obtained from patient records. Robust linear regression was used to assess temporal trends in PVR procedural volume. Piecewise exponential additive mixed models were used to estimate BPV durability, defined as the time from implantation to redo PVR with death as a competing risk, and to assess risk factors for reduced durability.

RESULTS:

In total, 546 PVR were performed in 384 patients from 1976 to 2021. The annual number of PVR increased from 0.4 to 6.0 per million population (P < 0.001). In the last decade, the transcatheter PVR volume increased by 20% annually (P < 0.001), whereas the surgical PVR volume did not change significantly. The median BPV durability was 17 years (Q1 10-Q3 10 years-not applicable). There was no significant difference in the durability of different BPV after adjustment for confounders. Age at PVR (HR 0.78 per 10 years from <1 year; 95% CI 0.63-0.96; P = 0.02) and true inner valve diameter (9-17 mm vs 18-22 mm HR 0.40; 95% CI 0.22-0.73; P = 0.003 and 18-22 mm vs 23-30 mm HR 0.59; 95% CI 0.25-1.39; P = 0.23) were associated with reduced BPV durability in multivariate models.

CONCLUSIONS:

The PVR procedural volume has increased over time, with a greater increment in transcatheter than surgical PVR during the last decade. Younger patient age at PVR and a smaller true inner valve diameter predicted reduced BPV durability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Pulmonar / Insuficiencia de la Válvula Pulmonar / Tetralogía de Fallot / Implantación de Prótesis de Válvulas Cardíacas Límite: Child / Humans Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Pulmonar / Insuficiencia de la Válvula Pulmonar / Tetralogía de Fallot / Implantación de Prótesis de Válvulas Cardíacas Límite: Child / Humans Idioma: En Revista: JACC Cardiovasc Interv Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos