Safety and efficacy of redo percutaneous pulmonary valve implantation after transcatheter valve failure: A multicentre observational study - 27/08/26
, Sebastien Hascoet 2, Peter Kramer 3, F. Berger 4, Christophe De Meester 5, Heike Schneider 6, Raymond Haddad 7, Aleksander Kempny 8, Alain Fraisse 9, Zakaria Jalal 10, Patrice Guérin 11, Ali Houeijeh 12, Bruno Lefort 13, Stanimir Georgiev 14, Sophie-Guiti Malekzadeh Milani 15Résumé |
Introduction |
Percutaneous pulmonary valve implantation (PPVI) is an established and increasingly used therapy for patients with dysfunctional right ventricular outflow tract (RVOT). We assessed the safety, efficacy, and early outcomes of redo-PPVI performed for dysfunctional transcatheter pulmonary valves.
Methods |
We conducted a retrospective, multicentre observational study including patients who underwent redo-PPVI.
Results |
Twenty-four centres enrolled a total of 162 patients (mean age 25.2 ± 11.5 years). The index valve was a Melody valve in 102 patients (63.0%), a Sapien valve in 59 (37.7%), and a Harmony valve in 1 (0.6%). The redo valve was a Melody valve in 87 patients (53.7%), a Sapien valve in 70 (43.2%), and a Myval valve in 5 (3.1%). The mean time from index PPVI to redo-PPVI was 7.4 ± 4.0 years. Indications for redo-PPVI were pulmonary regurgitation in 98 patients (60.5%), stenosis in 16 (9.9%), and mixed lesions in 48 (29.6%). Periprocedural complications occurred in 7.4% of patients without relationship with the specific setting of redo-PPVI, such as atrial lead dislocations ( n = 2) or vascular access complications ( n = 2). No periprocedural deaths or coronary complications were reported. During follow-up ( n = 148; median 3.3 years [0.9–6.0]), 6 patients died (3 due to de novo infective endocarditis, 1 due to heart failure) and 29 patients experienced adverse events (2 heart transplantation, 2 cases of heart failure, 9 cases of de novo endocarditis, 1 case of protein-losing enteropathy, 15 cases of sustained tachycardia including 4 ventricular tachycardia, and 11 atrial arrhythmias). Eighteen patients required reintervention: 14 underwent surgical pulmonary valve replacement and 4 underwent balloon dilatation. At last follow-up, none or mild regurgitation was present in 90.7% of patients, and the maximal transvalvular gradient was 26.5 ± 11.9 mmHg.
Conclusion |
Redo-PPVI appears to be a relatively safe and effective treatment option for patients with dysfunctional transcatheter pulmonary valves. However, the rate of significant complications highlights the need for close follow-up.
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Vol 119 - N° 8-9S
P. S260-S261 - août 2026 Retour au numéro
Article précédent
- Interstage outcomes in single ventricle neonates: Ductal stenting versus modified Blalock-Taussig shunt
- Valentin Vescovo, Sophie-Guiti Malekzadeh Milani, Régis Gaudin, Olivier Raisky, Margaux Pontailler, Segolene Bernheim, Mathilde Méot, Alexander Moiroux-Sahraoui, Damien Bonnet, Neil Derridj
- Outcomes of transcatheter patent ductus arteriosus closure in infants weighing 2 to 6 kg
- Paul Padovani, Sophie Malekzadeh-Milani, Kothandam Sivakumar, Thomas Goronflot, Mathilde Méot, Matthew Jones, Caroline Ovaert, Sebastien Hascoet, Zakaria Jalal, Carles Bautista-Rodriguez, Gianfranco Butera, Shak Qureshi, Alain Fraisse, Gareth Morgan, Alban-Elouen Baruteau
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