[III-JCKAP7-1-5] Short-term Changes in Cardiac Function Before and After Transcatheter Pulmonary Valve Implantation Using Medtronic TM
Keywords:Transcatheter pulmonary valve implantation, Right ventricular function, Cardiac MRI
Background: Since 2023, transcatheter pulmonary valve implantation (TPVI) using Medtronic HarmonyTM has been performed in Japan, and improvement in postoperative symptoms has been observed in many patients. Although the mid-term outcome such as survival and valve function of HarmonyTM have been reported, detailed analysis of cardiac function has not yet been conducted. The purpose of this study is to evaluate the functional changes occurring on TPVI.Methods: We included 20 consecutive patients (mean age 37±15 years) who underwent TPVI at our hospital and compared the various data using Wilcoxon rank sum test before and 1 month after TPVI. Results: Right ventricular (RV) pressure decreased from 39±10/8±3 mmHg to 37±11/8±5 mmHg, and main pulmonary artery systolic pressure increased from 7±4 mmHg to 12±6 mmHg. RV volume (end-diastole and end-systole) decreased from 167±25 mL/m2 and 92±23 mL/m2 to 121±25 mL/m2 and 70±13 mL/m2, respectively (both p<0.001), and ejection fraction (EF) showed a decreasing trend from 45±9% to 40±10% (p=0.05). Left ventricular volume and EF did not change significantly. Main pulmonary forward net flow increased from 62±20 mL to 83±22 mL (p = 0.005). BNP showed a trend towards improvement from 58±47 pg/dL to 40±26 pg/dL (p=0.07).Conclusion: Compared to before TPVI, there was a significant decrease in RV size just one month after surgery, although EF also decreased. Additional research is necessary to assess long-term changes, including the utilization of techniques such as 4D flow and strain analysis.