Differences in Right Heart Function After Pulmonary Valve Replacement in Patients With Pulmonary Valve Stenosis Versus Tetralogy of Fallot

There is limited data about the impact of timing of pulmonary valve replacement (PVR) on right heart reverse remodeling in patients with pulmonary regurgitation following intervention for isolated pulmonary valve stenosis (PS). This study compared differences in postprocedural right heart reverse remodeling after early versus late PVR (defined as PVR before versus after attainment of the conservative consensus criteria proposed by Bokma et al, 2018) in patients with prior intervention for PS, using patients with tetralogy of Fallot as the reference group. 
Right atrial reservoir strain and right ventricular free wall strain were measured at baseline, one and three years after PVR. There were 114 patients with PS (early PVR, 87 [76 percent]; late PVR, 27 [24 percent]) and 291 patients with tetralogy of Fallot (early PVR, 197 [67 percent]; late PVR, 96 [33 percent]). The PS group had greater improvement in right atrial reservoir strain at one year (12 percent ±4 percent versus 8 percent±4 percent; P