title: Tricuspid Regurgitation Does Not Impact Right Ventricular Remodeling After Percutaneous Pulmonary Valve Implantation.
abstract: This study sought to investigate the impact of tricuspid regurgitation (TR) on right ventricular function after percutaneous pulmonary valve implantation (PPVI).
  
  
  
  PPVI provides a less invasive alternative to surgery in patients with right ventricular-to-pulmonary artery (RV-PA) conduit dysfunction. Recovery of the right ventricle has been described after PPVI for patients with pulmonary stenosis and for those with pulmonary regurgitation. Additional TR enforces RV dysfunction by supplemental volume overload. Limited data are available on the potential of the right ventricle to recover in such a specific hemodynamic situation.
  
  
  
  In a matched cohort study, we compared patients who underwent PPVI with additional TR with those without TR.
  
  
  
  The degree of TR improved in 83% of the patients. In our patients (n = 36) exercise capacity and right ventricular volume index improved similarly 6 months after PPVI in patients with and without important TR. None of them had significant TR in the long-term follow-up of median 78 months.
  
  
  
  PPVI improves not only RV-PA-conduit dysfunction, but also concomitant TR. In patients with a dysfunctional RV-PA conduit and TR, the decision whether to fix TR should be postponed after PPVI.
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany. Electronic address: tanase@dhm.mhn.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tanase
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.
authors.forename: Stanimir
authors.initials: S
authors.lastname: Georgiev
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Meierhofer
authors.affiliation: Department of Cardiovascular Surgery, German Heart Centre of the Technical University Munich, Munich, Germany.
authors.forename: Jelena
authors.initials: J
authors.lastname: Pabst von Ohain
authors.affiliation: Lucille Packard Children's Hospital Stanford, Palo Alto, California.
authors.forename: Doff B
authors.initials: DB
authors.lastname: McElhinney
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.
authors.forename: Alfred
authors.initials: A
authors.lastname: Hager
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kühn
authors.affiliation: Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre of the Technical University Munich, Munich, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Eicken
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D004452:Echocardiography; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016278:Ventricular Function, Right; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D020257:Ventricular Remodeling; D055815:Young Adult
keywords: PPVI; RVEDVi; pulmonary valve replacement; tricuspid regurgitation