Skip to main content

Advertisement

SpringerLink
Log in

Four-year cardiac magnetic resonance (CMR) follow-up of patients treated with percutaneous pulmonary valve stent implantation

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate follow-up after percutaneous pulmonary valve implantation (PPVI).

Methods

Forty patients with pulmonary conduit dysfunction (males/females 24/16; 21 ± 08 years; 12 tetralogy of Fallot, 11 aortic valve disease, 17 other congenital heart disease) were planned for CMR before PPVI and repeated 7 times up to 48 months. CMR prospective results regarded: pressure gradient (PG) and regurgitation fraction (RF); end-diastolic volume, end-systolic volume, and stroke volume indexed to body surface area (EDVI, ESVI, and SVI); ejection fraction (EF) of right and left ventricles (RV, LV). A Friedman test was used for comparisons.

Results

Overall, PG (31 ± 06 to 16 ± 4 mmHg), RF (16 ± 17 to 0.3 ± 1 %), RVEDVI (82 ± 38 to 58 ± 12 ml/m2), and RVESVI (44 ± 12 to 30 ± 13 ml/m2) declined (p < 0.001), RVEF (49 ± 13 to 58 ± 12 %) and RVSVI (from 38 ± 14 to 40 ± 8 ml/m2) increased (p < 0.001), LVEDVI (67 ± 17 to 73 ± 18 ml/m2) and LVSVI (37 ± 11 to 43 ± 10 ml/m2) increased (p = 0.034 and p < 0.001). Two patients had valve fracture at 24 and 36 months and underwent surgery. One patient had stent restenosis at 24 months and underwent percutaneous retreatment. Baseline/follow-up CMR did not predict PPVI failure.

Conclusions

CMR demonstrated restored pulmonary conduit function, reduced RV volumes and increased RV and LV function but did not predict valve fracture/restenosis.

Key points

• A CMR 4-year follow-up after PPVI showed restored pulmonary conduit function

• RV volumes were significantly reduced

• RV function was significantly better in terms of increased EF and SVI

• LV function was significantly better in terms of increased EDVI and SVI

• Baseline/follow-up CMR did not predict three cases of PPVI failure

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Khambadkone S, Bonhoeffer P (2004) Nonsurgical pulmonary valve replacement: why, when, and how? Catheter Cardiovasc Interv 62:401–408

    Article  PubMed  Google Scholar 

  2. Bonhoeffer P, Boudjemline Y, Saliba Z et al (2000) Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet 356:1403–1405

    Article  CAS  PubMed  Google Scholar 

  3. Stark J (1998) The use of valved conduits in pediatric cardiac surgery. Pediatr Cardiol 19:282–288

    Article  CAS  PubMed  Google Scholar 

  4. Lurz P, Bonhoeffer P, Taylor AM (2009) Percutaneous pulmonary valve implantation: an update. Expert Rev Cardiovasc Ther 7:823–833

    Article  PubMed  Google Scholar 

  5. Eyskens B, Reybrouck T, Bogaert J et al (2000) Homograft insertion for pulmonary regurgitation after repair of tetralogy of fallot improves cardiorespiratory exercise performance. Am J Cardiol 85:221–225

    Article  CAS  PubMed  Google Scholar 

  6. Kanter KR, Budde JM, Parks WJ et al (2002) One hundred pulmonary valve replacements in children after relief of right ventricular outflow tract obstruction. Ann Thorac Surg 73:1801–1806

    Article  PubMed  Google Scholar 

  7. Gatzoulis MA, Elliott JT, Guru V et al (2000) Right and left ventricular systolic function late after repair of tetralogy of Fallot. Am J Cardiol 86:1352–1357

    Article  CAS  PubMed  Google Scholar 

  8. Conte S, Jashari R, Eyskens B et al (1999) Homograft valve insertion for pulmonary regurgitation late after valveless repair of right ventricular outflow tract obstruction. Eur J Cardiothorac Surg 15:143–149

    Article  CAS  PubMed  Google Scholar 

  9. Therrien J, Siu SC, Harris L et al (2001) Impact of pulmonary valve replacement on arrhythmia propensity late after repair of tetralogy of Fallot. Circulation 103:2489–2494

    Article  CAS  PubMed  Google Scholar 

  10. Li W, Davlouros PA, Kilner PJ et al (2004) Doppler-echocardiographic assessment of pulmonary regurgitation in adults with repaired tetralogy of Fallot: comparison with cardiovascular magnetic resonance imaging. Am Heart J 147:165–172

    Article  PubMed  Google Scholar 

  11. Valente AM, Cook S, Festa P et al (2014) Multimodality imaging guidelines for patients with repaired tetralogy of fallot: a report from the american society of echocardiography: developed in collaboration with the society for cardiovascular magnetic resonance and the society for pediatric radiology. J Am Soc Echocardiogr 27:111–141

    Article  PubMed  Google Scholar 

  12. McElhinney DB, Hellenbrand WE, Zahn EM et al (2010) Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation 122:507–516

    Article  PubMed Central  PubMed  Google Scholar 

  13. Eicken A, Ewert P, Hager A et al (2011) Percutaneous pulmonary valve implantation: two-centre experience with more than 100 patients. Eur Heart J 32:1260–1265

    Article  PubMed  Google Scholar 

  14. Lurz P, Nordmeyer J, Giardini A et al (2011) 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 57:724–731

    Article  PubMed  Google Scholar 

  15. Hendel RC, Patel MR, Kramer CM et al (2006) ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging: a report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. J Am Coll Cardiol 48:1475–1497

    Article  PubMed  Google Scholar 

  16. Secchi F, Resta EC, Piazza L et al (2014) Cardiac magnetic resonance before and after percutaneous pulmonary valve implantation. Radiol Med 119:400–407

    Article  PubMed  Google Scholar 

  17. Secchi F, Di Leo G, Papini GD et al (2011) Cardiac magnetic resonance: impact on diagnosis and management of patients with congenital cardiovascular disease. Clin Radiol 66:720–725

    Article  CAS  PubMed  Google Scholar 

  18. Vogt FM, Theysohn JM, Michna D et al (2013) Contrast-enhanced time-resolved 4D MRA of congenital heart and vessel anomalies: image quality and diagnostic value compared with 3D MRA. Eur Radiol 23:2392–2404

    Article  PubMed  Google Scholar 

  19. Van Dijck I, Budts W, Cools B et al (2014) Infective endocarditis of a transcatheter pulmonary valve in comparison with surgical implants. Heart 0:1–6

    Google Scholar 

  20. Kramer CM, Barkhausen J, Flamm SD, Kim RJ, Nagel E (2013) Society for Cardiovascular Magnetic Resonance Board of Trustees Task Force on Standardized Protocols. Standardized cardiovascular magnetic resonance (CMR) protocols 2013 update. J Cardiovasc Magn Reson 15:91

    Article  PubMed Central  PubMed  Google Scholar 

  21. Caudron J, Fares J, Lefebvre V, Vivier PH, Petitjean C, Dacher JN (2012) Cardiac MRI, assessment of right ventricular function in acquired heart disease: factors of variability. Acad Radiol 19(8):991–1002

    Article  PubMed  Google Scholar 

  22. Kilner PJ, Gatehouse PD, Firmin DN (2007) Flow measurement by magnetic resonance: a unique asset worth optimising. J Cardiovasc Magn Reson 9:723–728

    Article  PubMed  Google Scholar 

  23. Secchi F, Iozzelli A, Papini GD et al (2009) MR imaging of aortic coarctation. Radiol Med 114:524–537

    Article  CAS  PubMed  Google Scholar 

  24. Butera G, Milanesi O, Spadoni I et al (2013) Melody transcatheter pulmonary valve implantation. Results from the registry of the Italian Society of Pediatric Cardiology. Catheter Cardiovasc Interv 81:310–316

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The scientific guarantor of this publication is Professor Francesco Sardanelli. M Carminati is consultant/proctor for Medtronic and Edwards; F. Sardanelli has received research grants from and is a member of the speakers’ bureau for Bracco Imaging. The remaining authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Methodology: retrospective, observational, performed at one institution.

Author information

Authors and Affiliations

  1. Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy

    Francesco Secchi & Francesco Sardanelli

  2. Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20100, Milan, Italy

    Elda Chiara Resta & Paola Maria Cannaò

  3. Azienda Ospedaliera San Paolo, Unit of Diagnostic and Interventional Radiology, via A. di Rudinì 8, 20142, Milan, Italy

    Silvia Tresoldi

  4. Unit of Paediatric Cardiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy

    Gianfranco Butera & Mario Carminati

  5. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy

    Francesco Sardanelli

Authors
  1. Francesco Secchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elda Chiara Resta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paola Maria Cannaò
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Silvia Tresoldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gianfranco Butera
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mario Carminati
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesco Sardanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Secchi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Secchi, F., Resta, E.C., Cannaò, P.M. et al. Four-year cardiac magnetic resonance (CMR) follow-up of patients treated with percutaneous pulmonary valve stent implantation. Eur Radiol 25, 3606–3613 (2015). https://doi.org/10.1007/s00330-015-3781-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-015-3781-5

Keywords

Search

Navigation