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Acute and short-term haemodynamic impact of transcatheter pulmonary valve implantation on left ventricular systolic and diastolic function

Part of: Tetralogy of Fallot (TOF) Echocardiography Interventional Cardiology

Published online by Cambridge University Press:  16 March 2021

Ryan A. Romans Open the ORCID record for Ryan A. Romans [Opens in a new window] ,
Wendy Whiteside ,
Sunkyung Yu ,
Lori Harris ,
Veronika Dottermann  and
Jeffrey D. Zampi
Ryan A. Romans*
Affiliation:
Department of Cardiology, Children’s Mercy Kansas City and Ward Family Heart Center, Kansas City, MO, USA
Wendy Whiteside
Affiliation:
Division of Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital and University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
Sunkyung Yu
Affiliation:
Division of Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital and University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
Lori Harris
Affiliation:
Division of Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital and University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
Veronika Dottermann
Affiliation:
Division of Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital and University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
Jeffrey D. Zampi
Affiliation:
Division of Cardiology, Department of Pediatrics, C.S. Mott Children’s Hospital and University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
*
Author for correspondence: Ryan Romans, MD, Department of Cardiology, 2401 Gillham Road, Children’s Mercy Kansas City and Ward Family Heart Center, Kansas City, MO64108, USA. Tel: +(816) 302-3649; Fax: (816) 302-9987. E-mail: raromans@cmh.edu
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Abstract

Objectives:

Assess the acute and short-term haemodynamic impact of transcatheter pulmonary valve implantation on left ventricular systolic and diastolic function stratified by pre-transcatheter pulmonary valve implantation physiology.

Background:

Transcatheter pulmonary valve implantation is a widely available option to treat residual or recurrent pulmonary stenosis and pulmonary insufficiency. Transcatheter pulmonary valve implantation acutely increases pulmonary artery size and diastolic pressure in patients with pulmonary insufficiency and acute pulmonary edema has been reported after transcatheter pulmonary valve implantation, possibly related to acute left ventricular volume loading. However, the impact of transcatheter pulmonary valve implantation on left ventricular diastolic function has not been established.

Methods:

Patients who underwent transcatheter pulmonary valve implantation from 2010 to 2017 at our centre were grouped by indication for transcatheter pulmonary valve implantation as pulmonary stenosis, pulmonary insufficiency, or mixed disease. Separate analysis was performed on those who underwent transcatheter pulmonary valve implantation for pulmonary stenosis versus pulmonary insufficiency or mixed disease. Intracardiac haemodynamics immediately before and after transcatheter pulmonary valve implantation and echocardiographic assessment of left ventricular systolic and diastolic function at baseline, 1-day post transcatheter pulmonary valve implantation, and 1-year post transcatheter pulmonary valve implantation were compared between groups.

Results:

In 102 patients who underwent transcatheter pulmonary valve implantation, the indication was pulmonary stenosis in 29 (28%), pulmonary insufficiency in 28 (29%), and mixed disease in 44 (43%). There were no significant differences in left ventricular systolic or diastolic function between groups at baseline, immediately after transcatheter pulmonary valve implantation, or 1-year post implantation. The mean pulmonary artery wedge pressure increased equally across groups.

Conclusions:

While patients with pulmonary insufficiency likely have acute left ventricular volume loading following transcatheter pulmonary valve implantation, this does not appear to be haemodynamically significant as transcatheter pulmonary valve implantation was not associated with measurable changes in left ventricular systolic or diastolic function acutely or 1-year post implantation.

Keywords

Cardiac catheterisationheart valve prosthesis implantationtranscatheter pulmonary valve implantationcongenital heart defects
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 11 , November 2021 , pp. 1835 - 1841
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Lurz, P, Puranik, R, Nordmeyer, J, et al. Improvement in left ventricular filling properties after relief of right ventricle to pulmonary artery conduit obstruction: contribution of septal motion and interventricular mechanical delay. Eur Heart J 2009; 30: 2266–2274. doi: 10.1093/eurheartj/ehp258. Epub 2009 Jun 26. PubMed PMID: 19561027.CrossRefGoogle ScholarPubMed
Lurz, P, Nordmeyer, J, Giardini, A, et al. Early versus late functional outcome after successful percutaneous pulmonary valve implantation: are the acute effects of altered right ventricular loading all we can expect? J Am Coll Cardiol 2011; 57: 724–731. doi: 10.1016/j.jacc.2010.07.056. PubMed PMID: 21292132.CrossRefGoogle ScholarPubMed
Zablah, JE, Misra, N, Gruber, D, Kholwadwala, D, Epstein, S. Comparison of patients undergoing surgical versus transcatheter pulmonary valve replacement: criteria for referral and mid-term outcome. Pediatr Cardiol 2017; 38: 603–607.CrossRefGoogle ScholarPubMed
McElhinney, DB, Hellenbrand, WE, Zahn, EM, et al. Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation 2010; 122: 507–516.CrossRefGoogle Scholar
Frigiola, A, Tsang, V, Bull, C, et al. Biventricular response after pulmonary valve replacement for right ventricular outflow tract dysfunction: is age a predictor of outcome? Circulation 2008; 118(Suppl 14): S182–S190.CrossRefGoogle ScholarPubMed
Chowdhury, SM, Hijazi, ZM, Rhodes, J, et al. Early echocardiographic changes after percutaneous implantation of the Edwards SAPIEN transcatheter heart valve in the pulmonary position. Echocardiography 2013; 30: 786–793.CrossRefGoogle ScholarPubMed
Chalard, A, Sanchez, I, Gouton, M, et al. Effect of pulmonary valve replacement on left ventricular function in patients with tetralogy of Fallot. Am J Cardiol 2012; 110: 1828–1835.CrossRefGoogle ScholarPubMed
Tobler, D, Crean, AM, Redington, AN, et al. The left heart after pulmonary valve replacement in adults late after tetralogy of Fallot repair. Int J Cardiol 2012; 160: 165–170.CrossRefGoogle ScholarPubMed
Kane, C, Kogon, B, Pernetz, M, et al. Left ventricular function improves after pulmonary valve replacement in patients with previous right ventricular outflow tract reconstruction and biventricular dysfunction. Tex Heart Inst J 2011; 38: 234–237.Google ScholarPubMed
Harrild, DM, Marcus, E, Hasan, B, et al. Impact of transcatheter pulmonary valve replacement on biventricular strain and synchrony assessed by cardiac magnetic resonance feature tracking. Circ Cardiovasc Interv 2013; 6: 680–687.CrossRefGoogle ScholarPubMed
Lunze, FI, Hasan, BS, Gauvreau, K, et al. Progressive intermediate-term improvement in ventricular and atrioventricular interaction after transcatheter pulmonary valve replacement in patients with right ventricular outflow tract obstruction. Am Heart J 2016; 179: 87–98.CrossRefGoogle ScholarPubMed
Coats, L, Khambadkone, S, Derrick, G, et al. Physiological consequences of percutaneous pulmonary valve implantation: the different behaviour of volume- and pressure-overloaded ventricles. Eur Heart J 2007; 28: 1886–1893. Epub 2007 Jun 26. PubMed PMID: 17595193.CrossRefGoogle ScholarPubMed
Secchi, F, Resta, EC, Cannaò, PM, et al. Four-year cardiac magnetic resonance (CMR) follow-up of patients treated with percutaneous pulmonary valve stent implantation. Eur Radiol 2015; 25: 3606–3613. doi: 10.1007/s00330-015-3781-5. Epub 2015 May 21. PubMed PMID: 25991479.CrossRefGoogle ScholarPubMed
Lurz, P, Muthurangu, V, Schuler, PK, et al. Impact of reduction in right ventricular pressure and/or volume overload by percutaneous pulmonary valve implantation on biventricular response to exercise: an exercise stress real-time CMR study. Eur Heart J 2012; 33: 2434–2441. doi: 10.1093/eurheartj/ehs200. Epub 2012 Jul 12. PubMed PMID: 22798559; PubMed Central PMCID: PMC3461407.CrossRefGoogle ScholarPubMed
Lurz, P, Riede, FT, Taylor, AM, et al. Impact of percutaneous pulmonary valve implantation for right ventricular outflow tract dysfunction on exercise recovery kinetics. Int J Cardiol 2014; 177: 276–280. doi: 10.1016/j.ijcard.2014.09.014. Epub 2014 Sep 22. PubMed PMID: 25499392.CrossRefGoogle ScholarPubMed
Coats, L, Khambadkone, S, Derrick, G, et al. Physiological and clinical consequences of relief of right ventricular outflow tract obstruction late after repair of congenital heart defects. Circulation 2006; 113: 2037–2044. Epub 2006 Apr 24. PubMed PMID: 16636174.CrossRefGoogle ScholarPubMed
Callahan, R, Bergersen, L, Lock, JE, Marshall, AC Transcatheter pulmonary valve replacement and acute increase in diastolic pressure are associated with increases in both systolic and diastolic pulmonary artery dimensions. Pediatr Cardiol 2017; 38: 456–464.CrossRefGoogle ScholarPubMed
Alsulami, G, Patel, M, Malekzadeh-Milani, S, Bonnet, D, Boudjemline, Y. Hyperacute flash pulmonary oedema after transcatheter pulmonary valve implantation: the melody of an overwhelmed left ventricle. Arch Cardiovasc Dis 2014; 107: 219–224.CrossRefGoogle ScholarPubMed
Lubert, AM, Cotts, TB, Zampi, JD, Yu, S, Norris, MD. Echocardiographic predictors of eleveated left ventricular end diastolic pressure in adolescent and adult patients with repaired tetralogy of Fallot. Cardiol Young 2019; 29: 1020–1024. CrossRefGoogle Scholar