Effects of Transcatheter Pulmonary Valve Replacement on the Hemodynamic and Ventricular Response to Exercise in Patients With Obstructed Right Ventricle-to-Pulmonary Artery Conduits

摘要: Objectives This study sought to investigate the effects of exercise on right ventricle in patients with an obstructed ventricular outflow tract (RVOT) conduit before and after transcatheter pulmonary valve replacement (TPVR). Background Conventionally, assessment congenital heart disease dysfunctional RVOT conduits is performed at rest. However, this does not reflect dynamic changes. Methods Exercise stress echocardiography (ESE) 6 months TPVR was performed. ESE protocol included measurement rest immediate post-exercise maximal instantaneous gradients (MIGs), (RV) systolic pressure, 2-dimensional fractional area change, global longitudinal strain (GLS). Results Twenty obstruction (median age, 18 years), majority (n = 14) tetralogy Fallot, completed study. Pre-TPVR, median resting MIG across 53 mm Hg (23 95 Hg) increased 93 (49 156 Hg; p o 2 (p = 0.01). Conclusions In conduits, resulted significant improvement in conduit stenosis RV function both peak cardiopulmonary function. The ability augment associated improved capacity TPVR.