Background Complications and need for reinterventions are frequent in patients with pulmonary valve stenosis (PVS). Pulmonary regurgitation is common, but no data are available on outcome after pulmonary valve replacement (PVR). Methods We performed a retrospective analysis of 215 patients with PVS who underwent surgical valvotomy or balloon valvuloplasty. Incidence and predictors of reinterventions and complications were identified. Right ventricle (RV) remodelling after PVR was also assessed. Results After a median follow-up of 38.6 (30.9–49.4) years, 93% of the patients were asymptomatic. Thirty-nine patients (18%) had at least one PVR. Associated right ventricular outflow tract (RVOT) intervention and the presence of an associated defect were independent predictors of reintervention (OR: 4.1 (95% CI 1.5 to 10.8) and OR: 3.6 (95% CI 1.9 to 6.9), respectively). Cardiovascular death occurred in 2 patients, and 29 patients (14%) had supraventricular arrhythmia. Older age at the time of first intervention and the presence of an associated defect were independent predictors of complications (OR: 1.0 (95% CI 1.0 to 1.1) and OR: 2.1 (95% CI 1.1 to 4.2), respectively). In 16 patients, cardiac magnetic resonance before and after PVR was available. The optimal cut-off values for RV volume normalisation were 193 mL/m2 for RV end-diastolic volume indexed(sensitivity 80%, specificity 64%) and 100 mL/m2 for RV end-systolic volume indexed(sensitivity 80%, specificity 56%). Conclusions Previous RVOT intervention, presence of an associated defect and older age at the time of first repair were predictors of outcome. More data are needed to guide timing of PVR, and extrapolation of tetralogy of Fallot guidelines to this population is unlikely to be appropriate. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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肺动脉狭窄瓣膜置换术后的结果和右心室重构

背景 肺动脉瓣狭窄 (PVS) 患者经常出现并发症并需要再次干预。肺动脉瓣反流很常见，但没有关于肺动脉瓣置换术 (PVR) 后结果的数据。方法 我们对 215 例接受手术瓣膜切开术或球囊瓣膜成形术的 PVS 患者进行了回顾性分析。确定了再干预和并发症的发生率和预测因素。还评估了 PVR 后的右心室 (RV) 重塑。结果 在中位随访 38.6 (30.9–49.4) 年之后，93% 的患者没有症状。39 名患者 (18%) 至少有一处 PVR。相关右心室流出道 (RVOT) 干预和相关缺陷的存在是再次干预的独立预测因子（OR：4.1（95% CI 1.5 至 10.8）和 OR：3.6（95% CI 1.9 至 6.9），分别）。2 例患者发生心血管死亡，29 例 (14%) 患者出现室上性心律失常。首次干预时年龄较大和存在相关缺陷是并发症的独立预测因子（OR：1.0（95% CI 1.0 至 1.1）和 OR：2.1（95% CI 1.1 至 4.2））。在 16 名患者中，PVR 前后的心脏磁共振可用。RV 容积正常化的最佳截止值为 RV 舒张末期容积指数（敏感性 80%，特异性 64%）和 RV 收缩末期容积指数（敏感性 80%，特异性 56）的 100 mL/m2 %)。结论 既往 RVOT 干预、存在相关缺陷和首次修复时年龄较大是结果的预测因素。需要更多数据来指导 PVR 的时间安排，将法洛四联症指南外推到这一人群不太可能是合适的。所有与研究相关的数据都包含在文章中或作为补充信息上传。