Improved exercise performance and quality of life after percutaneous pulmonary valve implantation.
OBJECTIVE
Percutaneous pulmonary valve implantation (PPVI) has emerged as a new approach to treat patients with dysfunctional pulmonary valve conduits. Short- and midterm results have outlined hemodynamic improvements and increase in exercise performance. However, there is a lack of knowledge about quality of life at short term follow-up.


METHODS
From July 2007 to March 2013, we investigated 59 patients (17 female; median age 22.8 years) undergoing PPVI in our institution. 46 had predominant pulmonary stenosis (PS) and 13 had predominant pulmonary regurgitation (PR). They answered the quality of life questionnaire (SF-36) and underwent a cardiopulmonary exercise test and Cardiovascular Magnetic Resonance before and 6 months after PPVI.


RESULTS
Peak oxygen uptake improved significantly from 27.2 (18.9; 34.0) ml/min/kg to 29.2 (22.4; 35.3) ml/min/kg (p<.0001), and from 69.6 (55.9; 83.6) %predicted to 76.3 (67.9; 92.7) %predicted, respectively. Improvements were seen in both, the PS (71.9 to 78.3 %predicted; p<.0001) and PR (62.7 to 73.0 %predicted; p<.0001) group. Self-estimated quality of life was good already before PPVI but increased in almost all domains 6 months after PPVI in PS and PR group. Significant improvements developed in "physical function", "general health perception" and "health transition" in both groups, and "physical role functioning", "vitality" and "mental health" only in the PS group.


CONCLUSIONS
In patients with dysfunctional pulmonary valve conduits exercise performance and quality of life improve substantially 6months after successful percutaneous pulmonary valve implantation.
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany. Electronic address: j.mueller@tum.de.
Jan
J
Müller
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Andrea
A
Engelhardt
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Sohrab
S
Fratz
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Andreas
A
Eicken
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Peter
P
Ewert
Department of Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
Alfred
A
Hager
D000328:Adult; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000523:psychology / Q000639:trends*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011665:Pulmonary Valve Insufficiency / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology; D055815:Young Adult
Cardiopulmonary exercise test; Congenital heart disease; Intervention; Melody®; PPVI; Percutaneous pulmonary valve implantation; Quality of life; Sapien®