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Percutaneous Pulmonary Valve implantation (PPVI): Analysis of cases in a Bangladeshi Center

DOI : https://doi.org/10.36349/easjms.2020.v02i08.002
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As a resource constraint country, it was a difficult task to introduce percutaneous pulmonary valve implantation (PPVI) with MelodyTM. We aimed to see the outcome of our cases in this background. Retrospective analysis of six cases who had PPVI with MelodyTM in Combined Military Hospital, Bangladesh. Inclusion criteria were dysfunctional conduit between right ventricle (RV) and pulmonary artery causing (a) Symptoms of exceptional dyspnoea of various grade(NYHA II,III, IV) (b) RVEVD >150ml/m2+regurgitant fraction >40% (c) RVOT peak instantaneous gradient > 30 mm Hg. (d) RV dysfunction (RVEF<40%). Patient fulfilled above criteria were selected and outcome were analyzed. Mean age was 9 .56 + 2.96 years, weight was 28.75 + 8.61 kg, height was 137.5 + 17.52 cm. Mean age at surgery was 4.25+2.72 years. Female were 66.66%. Aortic homograft was used in 66.66 % cases. Eighteen mm Ensemble was used in four (66.66%) cases and 20mm and 22 mm in one each. Immediate result was excellent with no residual PS in two cases and negligible residual flow acceleration across pulmonary valve in four cases. No PR seen in all except one. One patient developed bacterial endocarditis after 3 years and was treated. Aim of PPVI is to prolong the life expectancy of conduits which were placed surgically from right ventricle to pulmonary artery. It significantly reduces the number of surgeries to change conduit in total life span of patient

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Dr. Afroza Begum

Lecturer, Dept. of Pharmacology and Therapeutics, Shaheed Monsur Ali Medical College & Hospital, Uttara, Dhaka-1230, Bangladesh

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