Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:283-90 - Vol. 71 Num.04 DOI: 10.1016/j.rec.2017.07.013

Pediatrics Spanish Registry of Percutaneous Melody Pulmonary Valve Implantation in Patients Younger Than 18 Years

Ruth Solana-Gracia a,b,, Fernando Rueda c, Pedro Betrián d, Federico Gutiérrez-Larraya e, María Jesús del Cerro f, Manuel Pan g, Juan Alcíbar h, José Félix Coserría i, José Manuel Velasco j, José Luis Zunzunegui b,k

a Unidad de Cardiología Infantil, Hospital Universitario Infanta Leonor, Madrid, Spain
b Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
c Unidad de Cardiología Infantil, Hospital Universitario A Coruña, A Coruña, Spain
d Servicio de Cardiología, Hospital Universitario Vall d’Hebron, Barcelona, Spain
e Servicio de Cardiología Infantil, Hospital Universitario La Paz, Madrid, Spain
f Servicio de Cardiología Infantil, Hospital Universitario Ramón y Cajal, Madrid, Spain
g Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
h Servicio de Cardiología, Hospital Universitario de Cruces, Bilbao, Vizcaya, Spain
i Servicio de Cardiología Infantil, Hospital Virgen del Rocío, Sevilla, Spain
j Instituto Pediátrico del Corazón, Hospital Universitario 12 de Octubre, Madrid, Spain
k Unidad de Cardiología Infantil, Hospital Universitario Gregorio Marañón, Madrid, Spain

Keywords

Percutaneous valve implant. Congenital heart disease. Structural catheterization. Pediatrics.

Abstract

Introduction and objectives

A decade has passed since the first Spanish percutaneous pulmonary Melody valve implant (PPVI) in March 2007. Our objective was to analyze its results in terms of valvular function and possible mid-term follow-up complications.

Methods

Spanish retrospective descriptive multicenter analysis of Melody PPVI in patients < 18 years from the first implant in March 2007 until January 1, 2016.

Results

Nine centers were recruited with a total of 81 PPVI in 77 pediatric patients, whose median age and weight were 13.3 years (interquartile range [IQR], 9.9-15.4) and 46 kg (IQR, 27-63). The predominant cardiac malformation was tetralogy of Fallot (n = 27). Most of the valves were implanted on conduits, especially bovine xenografts (n = 31). The incidence of intraprocedure and acute complications was 6% and 8%, respectively (there were no periprocedural deaths). The median follow-up time was 2.4 years (IQR, 1.1-4.9). Infective endocarditis (IE) was diagnosed in 4 patients (5.6%), of which 3 required surgical valve explant. During follow-up, the EI-related mortality rate was 1.3%. At 5 years of follow-up, 80% ± 6.9% and 83% ± 6.1% of the patients were free from reintervention and pulmonary valve replacement.

Conclusions

Melody PPVI was safe and effective in pediatric patients with good short- and mid-term follow-up hemodynamic results. The incidence of IE during follow-up was relatively low but was still the main complication.

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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