Ten Years of Percutaneous Pulmonary Valve Implantation in Australia and New Zealand - 20/12/22

Doi : 10.1016/j.hlc.2022.07.008

Claire M. Lawley, PhD ^a,^b,^⁎ , David Tanous, PhD ^a,^c, Clare O’Donnell, MBChB ^d, Benjamin Anderson, MBBS ^e, Nicholas Aroney, MBBS ^f, Darren L. Walters, MPhil ^f,^g, Stephen Shipton, MBChB ^h, William Wilson, MBBS ⁱ, David S. Celermajer, PhD ^j, Philip Roberts, MBChB ^a
^a The Heart Centre for Children, The Children’s Hospital at Westmead, Sydney Children’s Hospitals Network, Sydney, NSW, Australia
^b The University of Sydney Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
^c Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia
^d Green Lane Paediatric and Congenital Cardiac Service, Starship/Auckland City Hospitals, Starship Children’s Hospital, Auckland, New Zealand
^e Queensland Paediatric Cardiac Service, Queensland Children’s Hospital, Brisbane, Qld, Australia
^f Department of Cardiology, The Prince Charles Hospital, Brisbane, Qld, Australia
^g The University of Queensland, Brisbane, Qld, Australia
^h Children’s Cardiac Centre, Perth Children’s Hospital, Perth, WA, Australia
ⁱ Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Vic, Australia
^j Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia

^∗Corresponding author at: Dr Claire Lawley, PhD, The Heart Centre for Children, The Children’s Hospital at Westmead, Sydney Children’s Hospitals Network, Sydney, NSW, AustraliaThe Heart Centre for ChildrenThe Children’s Hospital at WestmeadSydney Children’s Hospitals NetworkSydneyNSWAustralia

Abstract

Objective

This study sought to investigate the characteristics, morbidity (including the rate of infective endocarditis and valve replacement) and mortality of individuals undergoing percutaneous pulmonary valve implantation in Australia and New Zealand since the procedure has been performed.

Background

The outcomes of percutaneous pulmonary valve implantation in Australia and New Zealand have not been evaluated. Recent international data, including patients from New Zealand, suggests the rate of infective endocarditis is not insignificant.

Methods

A retrospective multi-site cohort study was undertaken via medical record review at the centres where percutaneous pulmonary valve implantation has been performed. All procedures performed from 2009—March 2018 were included. Individuals were identified from local institution databases. Data was collected and analysed including demographics, details at the time of intervention, haemodynamic outcome, post procedure morbidity and mortality. Multi-site ethics approval was obtained.

Results

One hundred and seventy-nine (179) patients attended the cardiac catheter laboratory for planned percutaneous pulmonary valve implantation. Of these patients, 172 underwent successful implantation. Tetralogy of Fallot and pulmonary atresia were the most common diagnoses. The median age at procedure was 19 years (range 3–60 yrs). There was a significant improvement in the acute haemodynamics in patients undergoing percutaneous pulmonary valve implantation for stenosis. Seven (7) patients (3.9%) experienced a major procedural/early post procedure complication (death, conversion to open procedure, cardiac arrest), including two deaths. The annualised rates of infective endocarditis and valve replacement were 4.6% and 3.8% respectively. There was one death related to infective endocarditis in follow-up.

Conclusions

Percutaneous pulmonary valve replacement is a relatively safe method of rehabilitating the right ventricular outflow tract.

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Keywords : Pulmonary valve, Congenital heart disease, Cardiac catheter

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Introduction

Materials and Methods

Results

Procedural Details and Procedural/Early Adverse Outcomes

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Vol 31 - N° 12

P. 1649-1657 - décembre 2022 Retour au numéro

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Ten Years of Percutaneous Pulmonary Valve Implantation in Australia and New Zealand - 20/12/22

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