Physiological and clinical consequences of relief of right ventricular outflow tract obstruction late after repair of congenital heart defects

Circulation
Louise CoatsAndrew M Taylor

Abstract

Right ventricular outflow tract obstruction (RVOTO) is a common problem after repair of congenital heart disease. Percutaneous pulmonary valve implantation (PPVI) can treat this condition without consequent pulmonary regurgitation or cardiopulmonary bypass. Our aim was to investigate the clinical and physiological response to relieving RVOTO. We studied 18 patients who underwent PPVI for RVOTO (72% male, median age 20 years) from a total of 93 who had this procedure for various indications. All had a right ventricular outflow tract (RVOT) gradient >50 mm Hg on echocardiography without important pulmonary regurgitation (less than mild or regurgitant fraction <10% on magnetic resonance imaging [MRI]). Cardiopulmonary exercise testing, tissue Doppler echocardiography, and MRI were performed before and within 50 days of PPVI. PPVI reduced RVOT gradient (51.4 to 21.7 mm Hg, P<0.001) and right ventricular systolic pressure (72.8 to 47.3 mm Hg, P<0.001) at catheterization. Symptoms and aerobic (25.7 to 28.9 mL.kg(-1).min(-1), P=0.002) and anaerobic (14.4 to 16.2 mL.kg(-1).min(-1), P=0.002) exercise capacity improved. Myocardial systolic velocity improved acutely (tricuspid 4.8 to 5.3 cm/s, P=0.05; mitral 4.7 to 5.5 cm/s, P=0.01), wher...Continue Reading

References

Aug 1, 1989·Journal of the American College of Cardiology·G J EnsingD D Mair
Aug 1, 1989·Journal of the American College of Cardiology·B ZeeviJ E Lock
Jun 1, 1986·Journal of Applied Physiology·W L BeaverB J Whipp
Oct 1, 1988·The American Journal of Cardiology·G F ShollerS P Sanders
Apr 1, 1986·Journal of the American College of Cardiology·P J CurrieA J Tajik
Mar 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·K BandoF J Puga
Jan 1, 1993·Journal of the American College of Cardiology·J MasuraI D Sullivan
Jul 4, 1996·The New England Journal of Medicine·C R ChenH J Li
Jan 22, 1998·The Journal of Thoracic and Cardiovascular Surgery·W G WilliamsE H Blackstone
Sep 12, 2001·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·C H LorenzT P Graham
May 22, 2002·Journal of the American College of Cardiology·Philipp BonhoefferDaniel Sidi
Aug 17, 2005·Circulation·Sachin KhambadkonePhilipp Bonhoeffer

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Citations

Jul 24, 2008·Pediatric Radiology·Andrew M Taylor
Nov 26, 2009·Current Treatment Options in Cardiovascular Medicine·Arun KumarZiyad M Hijazi
Mar 15, 2008·Cardiology in the Young·Philipp Lurz, Philipp Bonhoeffer
May 19, 2010·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Claudio CapelliSilvia Schievano
Sep 23, 2011·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Hopewell N NtsinjanaAndrew M Taylor
Feb 10, 2010·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Silvia SchievanoPhilipp Bonhoeffer
Mar 27, 2009·Coronary Artery Disease·Alessandra FrigiolaPhilipp Bonhoeffer
Nov 27, 2010·Expert Review of Cardiovascular Therapy·Simon T MacDonaldMassimo Chessa
Nov 9, 2011·Expert Review of Cardiovascular Therapy·Tobias Odenwald, Andrew M Taylor
Dec 25, 2012·Expert Review of Cardiovascular Therapy·Tara Bharucha, Luc Mertens
Jun 2, 2012·Expert Review of Cardiovascular Therapy·Damien Kenny, Ziyad M Hijazi
Dec 19, 2006·Expert Review of Cardiovascular Therapy·Johannes Nordmeyer, Philipp Bonhoeffer
Jul 11, 2009·Expert Review of Cardiovascular Therapy·Philipp LurzAndrew M Taylor
Dec 25, 2013·The Canadian Journal of Cardiology·William WilsonEric Horlick
Nov 28, 2013·Heart Failure Clinics·Darren MylotteDoff McElhinney
Jun 26, 2013·The Canadian Journal of Cardiology·Adrian DanceaGiuseppe Martucci
Apr 19, 2015·International Journal of Cardiology·Heike SchneiderMatthias Sigler
Apr 8, 2009·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Philipp LurzPhilipp Bonhoeffer
May 5, 2007·Cardiology Clinics·Anne Marie Valente, Andrew J Powell
Dec 3, 2014·Archives of Cardiovascular Diseases·Mehul PatelYounes Boudjemline
Dec 3, 2014·Archives of Cardiovascular Diseases·Sebastien HascoëtYounes Boudjemline
Nov 29, 2007·Journal of Interventional Cardiology·Silvia SchievanoPhilipp Bonhoeffer
Jul 6, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Marcin DemkowWitold Rużyłło
Oct 21, 2011·Congenital Heart Disease·Nathaniel W TaggartDonald J Hagler
Jul 10, 2013·Annals of the New York Academy of Sciences·Doff B McElhinney, Jill T Hennesen
Feb 26, 2016·Current Cardiology Reports·Joanna Ghobrial, Jamil Aboulhosn
Nov 3, 2007·Magnetic Resonance Imaging Clinics of North America·Anne Marie Valente, Andrew J Powell

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