Children recover quickly after percutaneous pulmonary valve implantation

Less pain, a faster return to everyday life, and potential lower health care costs are some of the potential benefits associated with percutaneous pulmonary valve implatation in children born with pulmonary outflow tract disorder, according to Brith Andresen‘s PhD thesis.


MAIN RESULTS:

  1. Children and young adults appreciate the quick return to normal life following percutaneous valve implantation.
  2. In the future, hospitals could save money on percutanous valve implantation.
  3. Fewer complications following percutaneous than surgical pulmonary valve implantation.

THESIS DEFENCE:

Thesis: Percutaneous pulmonary valve implantation impact on clinical outcome, patients self-reported health, psychosocial function, and hospital costs in patients with congenital heart disease
Candidate: Brith Andresen
Time: December 20, 2018 at 13:15
Place: Oslo University Hospital, Rikshospitalet: Green auditorium
Link to university website


SUMMARY:

(1) Ten children and young adults with congenital heart disease had a new pulmonary valve implanted with a minimally invasive percutaneous technique. Both the children and their families experienced a quick return to their normal life.

The patients who were interviewed were between 7 and 30 years of age, and the researchers also interviewed 18 next-of-kin. The patients emphasized how fast they were able to return to their regular daily life activities both physically and psychosocially, without the pain they previously had experienced following open-chest surgery. The caregivers also appreciated that they didn’t have to stay away from work for a long period of time.

(2) With only a slight reduction in the cost of the new pulmonary valve, the modern percutaneous treatment will become cost-effective compared to surgical valve replacement. Today, the price of the valve itself represents a five times higher cost than the prize of the device used for open-chest surgery. The total costs, however, are close to equal, because patients stay at the hospital on average eight days longer following hte surgical procedure.

The analyses are based on 20 percutaneously and 14 surgically treated patients between 8 and 53 years of age.

(3) Surgical as well as percutaneous replacement of the pulmonary valve have good clinical effect. However, only patients treated with the minimally invasive method reported psychosocial improvements such as better attention and less intrusive behaviour both three months and one year after the treatment. Moreover, this group of patients had no complications following the procedure, in contrast to those who had open surgery.

The study includes a total of 34 patients treated at Oslo University Hospital, most of them children.


REFERENCES:

(1) Andresen, B., Andersen, M. H., Lindberg, H., Døhlen, G., & Fosse, E. (2014). Perceived health after percutaneous pulmonary valve implantation: in-depth interviews of patients and next-of-kinBMJ open4(7), e005102.

(2) Andresen, B., Mishra, V., Lewandowska, M., Andersen, J. G., Andersen, M. H., Lindberg, H., Døhlen, G., & Fosse, E. (2016). In-hospital cost comparison between percutaneous pulmonary valve implantation and surgeryEuropean Journal of Cardio-Thoracic Surgery51(4), 747-753.

(3) Andresen, B., Døhlen, G., Diep, L. M., Lindberg, H., Fosse, E., & Andersen, M. H. (2018). Psychosocial and clinical outcomes of percutaneous versus surgical pulmonary valve implantationOpen heart5(1), e000758.