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. 2023 Oct 5:14:100478.
doi: 10.1016/j.ijcchd.2023.100478. eCollection 2023 Dec.

Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians

Biagio Castaldi  1 , Gianfranco Butera  2 , Massimo Chessa  3   4 , Lorenzo Galletti  2 , Alessandro Giamberti  5 , Luca Giugno  6 , Aurelio Secinaro  7 , Vladimiro Vida  8 , Giovanni Di Salvo  1 , Mario Carminati  6
Affiliations

Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians

Biagio Castaldi et al. Int J Cardiol Congenit Heart Dis. .

Erratum in

Abstract

Aim: Transcatheter Pulmonary Valve Implantation (TPVI), when feasible, is the first-line approach to pulmonary valve replacement. Our aim was to obtain a picture of current TPVI practice in Italy.

Methods: After conducting a literature review on TPVI, online surveys were devised by an Advisory Board of 10 experts from the three Italian reference centers for congenital heart diseases and sent electronically to physicians working either in implanting center or in referral non-implanting cardiologic centers.

Results: Approximately 450 physicians across Italy were invited to contribute. 82 (18%) physicians answered. EchoColorDoppler, electrocardiogram and cardiac magnetic resonance were considered the first line approach to monitor these patients, before and after TPVI.For non-implanting centers, reasons for non-referral of patients for PVR were: paucisymptomatic disease (67%) and patients' poor adherence to disease management programs (41%), but also the lack of connections with specialized centers (33%). For implanters, the main reasons for refraining from TPVI were: high risk for coronary compression (67% first rank), the need for concomitant cardiac surgical procedures (39% first rank) and the unsuitable anatomy of the conduit (39% first rank). The availability of new larger valves of a self-expandable nature was indicated as a key technological development for expanding the cohort of patients currently eligible for TPVI.

Conclusions: Despite a non-invasive imaging protocol for the follow up and selection of patients candidate to TPVI is well implemented in Italy, there is still a lack in connections between non-implanting and implanting centers.

Keywords: PVR; RVOT dysfunction; Survey; TPVI.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Biagio Castaldi reports financial support and travel were provided by Medtronic. Gianfranco Butera reports financial support was provided by Medronic. Massimo Chessa reports financial support was provided by Medtronic. Lorenzo Galletti reports financial support was provided by Medtronic. Alessandro Giamberti reports financial support was provided by Medtronic. Luca Giugno reports financial support was provided by Medtronic. Aurelio Secinaro reports financial support was provided by Medtronic. Vladimiro Vida reports financial support was provided by Medtronic. Giovanni Di Salvo reports financial support was provided by Medtronic. Mario Carminati reports financial support was provided by Medtronic.

Figures

Fig. 1
Fig. 1
Summary of respondents by group and region.
Fig. 2
Fig. 2
Parameters considered for referring patients for PVR - Group C survey PI: Pulmonary Insufficiency; PS: Pulmonary Stenosis; RV: Right Ventricle; LV: Left Ventricle; RVOT: Right Ventricular Outflow Tract.
Fig. 3
Fig. 3
Factors influencing delayed referral of PVR patients - Group C survey QoL: Quality of Life.
Fig. 4
Fig. 4
Main reported reasons leading respondent to refrain from TPVI - Group A survey RVOT: Right Ventricular Outflow Tract.
Fig. 5
Fig. 5
TPVI implanted patients' distribution - Group A survey. A) reports the Kruskal-Wallis test results on TPVI-treated patients distribution, according to their primary indication for the intervention, resulting in a significative difference between PI and PS implanted patients (p < 0.05). In boxplot charts, boxes indicate the interquartile range (IQR with the middle line corresponding to the median. Whiskers extend from each box to the farthest point within ±1.5 IQR. B) reports the Kruskal-Wallis test results on TPVI-treated patients distribution, according to their conduit type before the intervention, resulting in a significative difference between RVOT conduit and bioprosthetic valve patients (p = 0.001) and between native/patched RVOT and bioprosthetic valve patients (p = 0.01).
See this image and copyright information in PMC

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