Pulmonary Valve Replacement in Tetralogy of Fallot: Procedural Volume and Durability of Bioprosthetic Pulmonary Valves

Mathis Gröning; Morten Holdgaard Smerup; Kim Munk; Helle Andersen; Dorte Guldbrand Nielsen; Henrik Nissen; Ulrik Markus Mortensen; Annette Schophuus Jensen; Pernille Steen Bække; Jesper Bjerre; Morten Engholm; Niels Vejlstrup; Klaus Juul; Eva Vad Søndergaard; Hans Gustav Hørsted Thyregod; Henrik Ørbæk Andersen; Morten Helvind; Ole De Backer; Christian Jøns; Michael Rahbek Schmidt; Troels Højsgaard Jørgensen; Lars Sondergaard

doi:10.1016/j.jcin.2023.10.070

Pulmonary Valve Replacement in Tetralogy of Fallot: Procedural Volume and Durability of Bioprosthetic Pulmonary Valves

Mathis Gröning^*, Morten Holdgaard Smerup, Kim Munk, Helle Andersen, Dorte Guldbrand Nielsen, Henrik Nissen, Ulrik Markus Mortensen, Annette Schophuus Jensen, Pernille Steen Bække, Jesper Bjerre, Morten Engholm, Niels Vejlstrup, Klaus Juul, Eva Vad Søndergaard, Hans Gustav Hørsted Thyregod, Henrik Ørbæk Andersen, Morten Helvind, Ole De Backer, Christian Jøns, Michael Rahbek SchmidtTroels Højsgaard Jørgensen, Lars Sondergaard

^*Corresponding author af dette arbejde

Kardiologisk Afdeling

Publikation: Bidrag til tidsskrift › Artikel › Forskning › peer review

Abstract

BACKGROUND: Robust data on changes in pulmonary valve replacement (PVR) procedural volume and predictors of bioprosthetic pulmonary valve (BPV) durability in patients with tetralogy of Fallot (TOF) are scarce.

OBJECTIVES: This study sought to assess temporal trends in PVR procedural volume and BPV durability in a nationwide, retrospective TOF cohort.

METHODS: Data were obtained from patient records. Robust linear regression was used to assess temporal trends in PVR procedural volume. Piecewise exponential additive mixed models were used to estimate BPV durability, defined as the time from implantation to redo PVR with death as a competing risk, and to assess risk factors for reduced durability.

RESULTS: In total, 546 PVR were performed in 384 patients from 1976 to 2021. The annual number of PVR increased from 0.4 to 6.0 per million population (P < 0.001). In the last decade, the transcatheter PVR volume increased by 20% annually (P < 0.001), whereas the surgical PVR volume did not change significantly. The median BPV durability was 17 years (Q1: 10 years-Q3: not applicable). There was no significant difference in the durability of different BPV after adjustment for confounders. Age at PVR (HR: 0.78 per 10 years from <1 year; 95% CI: 0.63-0.96; P = 0.02) and true inner valve diameter (9-17 mm vs 18-22 mm HR: 0.40; 95% CI: 0.22-0.73; P = 0.003 and 18-22 mm vs 23-30 mm HR: 0.59; 95% CI: 0.25-1.39; P = 0.23) were associated with reduced BPV durability in multivariate models.

CONCLUSIONS: The PVR procedural volume has increased over time, with a greater increment in transcatheter than surgical PVR during the last decade. Younger patient age at PVR and a smaller true inner valve diameter predicted reduced BPV durability.

Originalsprog	Engelsk
Sider (fra-til)	217-227
Antal sider	11
Tidsskrift	JACC: Cardiovascular Interventions
Vol/bind	17
Udgave nummer	2
Tidlig onlinedato	29 nov. 2023
DOI	https://doi.org/10.1016/j.jcin.2023.10.070
Status	Udgivet - 22 jan. 2024

Bibliografisk note

Adgang til dokumentet

10.1016/j.jcin.2023.10.070Licens: CC BY

Citationsformater

Gröning, M., Smerup, M. H., Munk, K., Andersen, H., Nielsen, D. G., Nissen, H., Mortensen, U. M., Jensen, A. S., Bække, P. S., Bjerre, J., Engholm, M., Vejlstrup, N., Juul, K., Søndergaard, E. V., Thyregod, H. G. H., Andersen, H. Ø., Helvind, M., De Backer, O., Jøns, C., ... Sondergaard, L. (2024). Pulmonary Valve Replacement in Tetralogy of Fallot: Procedural Volume and Durability of Bioprosthetic Pulmonary Valves. JACC: Cardiovascular Interventions, 17(2), 217-227. https://doi.org/10.1016/j.jcin.2023.10.070

@article{0ecfc49d68a64d5eaee8261ca1940fc3,

title = "Pulmonary Valve Replacement in Tetralogy of Fallot: Procedural Volume and Durability of Bioprosthetic Pulmonary Valves",

abstract = "BACKGROUND: Robust data on changes in pulmonary valve replacement (PVR) procedural volume and predictors of bioprosthetic pulmonary valve (BPV) durability in patients with tetralogy of Fallot (TOF) are scarce.OBJECTIVES: This study sought to assess temporal trends in PVR procedural volume and BPV durability in a nationwide, retrospective TOF cohort.METHODS: Data were obtained from patient records. Robust linear regression was used to assess temporal trends in PVR procedural volume. Piecewise exponential additive mixed models were used to estimate BPV durability, defined as the time from implantation to redo PVR with death as a competing risk, and to assess risk factors for reduced durability.RESULTS: In total, 546 PVR were performed in 384 patients from 1976 to 2021. The annual number of PVR increased from 0.4 to 6.0 per million population (P < 0.001). In the last decade, the transcatheter PVR volume increased by 20% annually (P < 0.001), whereas the surgical PVR volume did not change significantly. The median BPV durability was 17 years (Q1: 10 years-Q3: not applicable). There was no significant difference in the durability of different BPV after adjustment for confounders. Age at PVR (HR: 0.78 per 10 years from <1 year; 95% CI: 0.63-0.96; P = 0.02) and true inner valve diameter (9-17 mm vs 18-22 mm HR: 0.40; 95% CI: 0.22-0.73; P = 0.003 and 18-22 mm vs 23-30 mm HR: 0.59; 95% CI: 0.25-1.39; P = 0.23) were associated with reduced BPV durability in multivariate models.CONCLUSIONS: The PVR procedural volume has increased over time, with a greater increment in transcatheter than surgical PVR during the last decade. Younger patient age at PVR and a smaller true inner valve diameter predicted reduced BPV durability.",

author = "Mathis Gr{\"o}ning and Smerup, {Morten Holdgaard} and Kim Munk and Helle Andersen and Nielsen, {Dorte Guldbrand} and Henrik Nissen and Mortensen, {Ulrik Markus} and Jensen, {Annette Schophuus} and B{\ae}kke, {Pernille Steen} and Jesper Bjerre and Morten Engholm and Niels Vejlstrup and Klaus Juul and S{\o}ndergaard, {Eva Vad} and Thyregod, {Hans Gustav H{\o}rsted} and Andersen, {Henrik {\O}rb{\ae}k} and Morten Helvind and {De Backer}, Ole and Christian J{\o}ns and Schmidt, {Michael Rahbek} and J{\o}rgensen, {Troels H{\o}jsgaard} and Lars Sondergaard",

year = "2024",

month = jan,

day = "22",

doi = "10.1016/j.jcin.2023.10.070",

language = "English",

volume = "17",

pages = "217--227",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier",

number = "2",

}

Gröning, M, Smerup, MH, Munk, K, Andersen, H, Nielsen, DG, Nissen, H, Mortensen, UM, Jensen, AS, Bække, PS, Bjerre, J, Engholm, M, Vejlstrup, N, Juul, K, Søndergaard, EV, Thyregod, HGH, Andersen, HØ, Helvind, M, De Backer, O, Jøns, C, Schmidt, MR, Jørgensen, TH & Sondergaard, L 2024, 'Pulmonary Valve Replacement in Tetralogy of Fallot: Procedural Volume and Durability of Bioprosthetic Pulmonary Valves', JACC: Cardiovascular Interventions, bind 17, nr. 2, s. 217-227. https://doi.org/10.1016/j.jcin.2023.10.070

TY - JOUR

T1 - Pulmonary Valve Replacement in Tetralogy of Fallot

T2 - Procedural Volume and Durability of Bioprosthetic Pulmonary Valves

AU - Gröning, Mathis

AU - Smerup, Morten Holdgaard

AU - Munk, Kim

AU - Andersen, Helle

AU - Nielsen, Dorte Guldbrand

AU - Nissen, Henrik

AU - Mortensen, Ulrik Markus

AU - Jensen, Annette Schophuus

AU - Bække, Pernille Steen

AU - Bjerre, Jesper

AU - Engholm, Morten

AU - Vejlstrup, Niels

AU - Juul, Klaus

AU - Søndergaard, Eva Vad

AU - Thyregod, Hans Gustav Hørsted

AU - Andersen, Henrik Ørbæk

AU - Helvind, Morten

AU - De Backer, Ole

AU - Jøns, Christian

AU - Schmidt, Michael Rahbek

AU - Jørgensen, Troels Højsgaard

AU - Sondergaard, Lars

PY - 2024/1/22

Y1 - 2024/1/22

N2 - BACKGROUND: Robust data on changes in pulmonary valve replacement (PVR) procedural volume and predictors of bioprosthetic pulmonary valve (BPV) durability in patients with tetralogy of Fallot (TOF) are scarce.OBJECTIVES: This study sought to assess temporal trends in PVR procedural volume and BPV durability in a nationwide, retrospective TOF cohort.METHODS: Data were obtained from patient records. Robust linear regression was used to assess temporal trends in PVR procedural volume. Piecewise exponential additive mixed models were used to estimate BPV durability, defined as the time from implantation to redo PVR with death as a competing risk, and to assess risk factors for reduced durability.RESULTS: In total, 546 PVR were performed in 384 patients from 1976 to 2021. The annual number of PVR increased from 0.4 to 6.0 per million population (P < 0.001). In the last decade, the transcatheter PVR volume increased by 20% annually (P < 0.001), whereas the surgical PVR volume did not change significantly. The median BPV durability was 17 years (Q1: 10 years-Q3: not applicable). There was no significant difference in the durability of different BPV after adjustment for confounders. Age at PVR (HR: 0.78 per 10 years from <1 year; 95% CI: 0.63-0.96; P = 0.02) and true inner valve diameter (9-17 mm vs 18-22 mm HR: 0.40; 95% CI: 0.22-0.73; P = 0.003 and 18-22 mm vs 23-30 mm HR: 0.59; 95% CI: 0.25-1.39; P = 0.23) were associated with reduced BPV durability in multivariate models.CONCLUSIONS: The PVR procedural volume has increased over time, with a greater increment in transcatheter than surgical PVR during the last decade. Younger patient age at PVR and a smaller true inner valve diameter predicted reduced BPV durability.

AB - BACKGROUND: Robust data on changes in pulmonary valve replacement (PVR) procedural volume and predictors of bioprosthetic pulmonary valve (BPV) durability in patients with tetralogy of Fallot (TOF) are scarce.OBJECTIVES: This study sought to assess temporal trends in PVR procedural volume and BPV durability in a nationwide, retrospective TOF cohort.METHODS: Data were obtained from patient records. Robust linear regression was used to assess temporal trends in PVR procedural volume. Piecewise exponential additive mixed models were used to estimate BPV durability, defined as the time from implantation to redo PVR with death as a competing risk, and to assess risk factors for reduced durability.RESULTS: In total, 546 PVR were performed in 384 patients from 1976 to 2021. The annual number of PVR increased from 0.4 to 6.0 per million population (P < 0.001). In the last decade, the transcatheter PVR volume increased by 20% annually (P < 0.001), whereas the surgical PVR volume did not change significantly. The median BPV durability was 17 years (Q1: 10 years-Q3: not applicable). There was no significant difference in the durability of different BPV after adjustment for confounders. Age at PVR (HR: 0.78 per 10 years from <1 year; 95% CI: 0.63-0.96; P = 0.02) and true inner valve diameter (9-17 mm vs 18-22 mm HR: 0.40; 95% CI: 0.22-0.73; P = 0.003 and 18-22 mm vs 23-30 mm HR: 0.59; 95% CI: 0.25-1.39; P = 0.23) were associated with reduced BPV durability in multivariate models.CONCLUSIONS: The PVR procedural volume has increased over time, with a greater increment in transcatheter than surgical PVR during the last decade. Younger patient age at PVR and a smaller true inner valve diameter predicted reduced BPV durability.

U2 - 10.1016/j.jcin.2023.10.070

DO - 10.1016/j.jcin.2023.10.070

M3 - Article

C2 - 38127022

SN - 1936-8798

VL - 17

SP - 217

EP - 227

JO - JACC: Cardiovascular Interventions

JF - JACC: Cardiovascular Interventions

IS - 2

ER -

Pulmonary Valve Replacement in Tetralogy of Fallot: Procedural Volume and Durability of Bioprosthetic Pulmonary Valves

Abstract

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