Early echocardiographic changes after percutaneous implantation of the Edwards SAPIEN transcatheter heart valve in the pulmonary position.

Published

Journal Article

To evaluate echocardiographic changes after SAPIEN valve implantation in the pulmonary position.The feasibility of the SAPIEN transcatheter pulmonary valve (TPV) has recently been demonstrated. We evaluated changes in pulmonary valve function and the right ventricle after SAPIEN TPV placement.We evaluated echocardiograms at baseline, discharge, 1 and 6 months after TPV placement in 33 patients from 4 centers. Pulmonary insufficiency severity was graded 0-4. TPV peak and mean gradients were measured. Right ventricular (RV) size and function were quantified using routine measures derived from color, spectral, and tissue Doppler indices and two-dimensional echocardiography.At baseline, 94% patients demonstrated pulmonary insufficiency grade 2-4. This decreased to 12% patients at 6 months (P < 0.01). TPV peak (P < 0.01) and mean gradient (P < 0.01) decreased. RV end-diastolic area indexed to body surface area (BSA) (P < 0.01), Tricuspid regurgitation (TR) gradient (P < 0.01), and the ratio of TR jet area to BSA (P < 0.01) decreased. Tricuspid inflow peak E:A, tissue Doppler imaging (TDI): septal E' and A', TDI: tricuspid A' improved between baseline and discharge, but trended back to baseline by 6-month follow-up. Tricuspid valve annulus z-score, RV area change, tricuspid annular plane systolic excursion (TAPSE), RV dP/dt, tricuspid E:E', and TDI: tricuspid annulus E' showed no change.Improvements in pulmonary insufficiency and stenosis, RV size, and TR gradient and severity are seen after SAPIEN TPV placement. Selected indices of RV diastolic function improve immediately after TPV implantation, but return to baseline by 6 months. RV systolic function is unchanged.

Full Text

Cited Authors

  • Chowdhury, SM; Hijazi, ZM; Rhodes, J; Kar, S; Makkar, R; Mullen, M; Cao, Q-L; King, L; Akin, J; Shirali, G

Published Date

  • August 2013

Published In

Volume / Issue

  • 30 / 7

Start / End Page

  • 786 - 793

PubMed ID

  • 23432507

Pubmed Central ID

  • 23432507

Electronic International Standard Serial Number (EISSN)

  • 1540-8175

International Standard Serial Number (ISSN)

  • 0742-2822

Digital Object Identifier (DOI)

  • 10.1111/echo.12147

Language

  • eng