RIGHT VENTRICULAR ADAPTATION TO VARYING LOADING CONDITIONS IN PATIENTS WITH CONGENITAL HEART DISEASE UNDERGOING PERCUTANEOUS PULMONARY VALVE IMPLANTATION

Abstract

Congenital heart disease (CHD) is the most common birth defect in new-born. In patients with a congenital heart disease (CHD), the right ventricle plays a key role in disease progression and prognosis. CHD patients often experience volume and/or pressure overloading of the right ventricle (RV) due to leaking or narrowing of the pulmonary valve. This can be fixed by replacing the valve during catheterization, this is called percutaneous pulmonary valve implantation (PPVI). However, the differences in the response of the right ventricle to volume and/or pressure overloading remain unclear. It is also still unclear when this response shifts towards harmful adaptation of the RV in these patients. Therefore, the optimal timing of PPVI remains unclear. Our study assessed the differences in RV response to pressure- and/or volume overload in CHD patients undergoing PPVI. We also assessed whether there were any parameters that could predict who would benefit most from PPVI, to improve the timing of PPVI. We found no differences in the RV response to volume and/or pressure overload groups. Furthermore, we found that patients with a higher pressure at the end of the filling of the right ventricle, right ventricular end-diastolic pressure (RVEDP), before PPVI were more likely to show improvement of the RV afterwards. Thus, RVEDP might help doctors to improve the timing of PPVI.