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Corno AF. Pulmonary Valve Regurgitation: Neither Interventional Nor Surgery Fits All. Front Pediatr 2018; 6:169. [PMID: 29951475 PMCID: PMC6008531 DOI: 10.3389/fped.2018.00169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/22/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction: PV implantation is indicated for severe PV regurgitation after surgery for congenital heart defects, but debates accompany the following issues: timing of PV implantation; choice of the approach, percutaneous interventional vs. surgical PV implantation, and choice of the most suitable valve. Timing of pulmonary valve implantation: The presence of symptoms is class I evidence indication for PV implantation. In asymptomatic patients indication is agreed for any of the following criteria: PV regurgitation > 20%, indexed end-diastolic right ventricular volume > 120-150 ml/m2 BSA, and indexed end-systolic right ventricular volume > 80-90 ml/m2 BSA. Choice of the approach: percutaneous interventional vs. surgical: The choice of the approach depends upon the morphology and the size of the right ventricular outflow tract, the morphology and the size of the pulmonary arteries, the presence of residual intra-cardiac defects and the presence of extremely dilated right ventricle. Choice of the most suitable valve for surgical implantation: Biological valves are first choice in most of the reported studies. A relatively large size of the biological prosthesis presents the advantage of avoiding a right ventricular outflow tract obstruction, and also of allowing for future percutaneous valve-in-valve implantation. Alternatively, biological valved conduits can be implanted between the right ventricle and pulmonary artery, particularly when a reconstruction of the main pulmonary artery and/or its branches is required. Hybrid options: combination of interventional and surgical: Many progresses extended the implantation of a PV with combined hybrid interventional and surgical approaches. Major efforts have been made to overcome the current limits of percutaneous PV implantation, namely the excessive size of a dilated right ventricular outflow tract and the absence of a cylindrical geometry of the right ventricular outflow tract as a suitable landing for a percutaneous PV implantation. Conclusion: Despite tremendous progress obtained with modern technologies, and the endless fantasy of researchers trying to explore new forms of treatment, it is too early to say that either the interventional or the surgical approach to implant a PV can fit all patients with good long-term results.
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Affiliation(s)
- Antonio F. Corno
- East Midlands Congenital Heart Centre, University Hospitals of Leicester, Leicester, United Kingdom
- Cardiovascular Research Center, University of Leicester, Leicester, United Kingdom
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de Torres-Alba F, Kaleschke G, Baumgartner H. Impact of Percutaneous Pulmonary Valve Implantation on the Timing of Reintervention for Right Ventricular Outflow Tract Dysfunction. ACTA ACUST UNITED AC 2018; 71:838-846. [PMID: 29859895 DOI: 10.1016/j.rec.2018.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/23/2018] [Indexed: 02/07/2023]
Abstract
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Early surgical repair has dramatically improved the outcome of this condition. However, despite the success of contemporary approaches with early complete repair, these are far from being curative and late complications are frequent. The most common complication is right ventricle outflow tract (RVOT) dysfunction, affecting most patients in the form of pulmonary regurgitation, pulmonary stenosis, or both, and can lead to development of symptoms of exercise intolerance, arrhythmias, and sudden cardiac death. Optimal timing of restoration of RVOT functionality in asymptomatic patients with RVOT dysfunction after TOF repair is still a matter of debate. Percutaneous pulmonary valve implantation, introduced almost 2 decades ago, has become a major game-changer in the treatment of RVOT dysfunction. In this article we review the pathophysiology, the current indications, and treatment options for RVOT dysfunction in patients after TOF repair with a focus on the role of percutaneous pulmonary valve implantation in the therapeutic approach to these patients.
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Affiliation(s)
- Fernando de Torres-Alba
- Department of Cardiology III - Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Muenster, Germany.
| | - Gerrit Kaleschke
- Department of Cardiology III - Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Muenster, Germany
| | - Helmut Baumgartner
- Department of Cardiology III - Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Muenster, Germany
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Zampi JD, Whiteside W. Innovative interventional catheterization techniques for congenital heart disease. Transl Pediatr 2018; 7:104-119. [PMID: 29770292 PMCID: PMC5938250 DOI: 10.21037/tp.2017.12.02] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 12/01/2017] [Indexed: 11/06/2022] Open
Abstract
Since 1929, when the first cardiac catheterization was safely performed in a human by Dr. Werner Forssmann (on himself), there has been a rapid progression of cardiac catheterization techniques and technologies. Today, these advances allow us to treat a wide variety of patients with congenital heart disease using minimally invasive techniques; from fetus to infants to adults, and from simple to complex congenital cardiac lesions. In this article, we will explore some of the exciting advances in cardiac catheterization for the treatment of congenital heart disease, including transcatheter valve implantation, hybrid procedures, biodegradable technologies, and magnetic resonance imaging (MRI)-guided catheterization. Additionally, we will discuss innovations in imaging in the catheterization laboratory, including 3D rotational angiography (3DRA), fusion imaging, and 3D printing, which help to make innovative interventional approaches possible.
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Affiliation(s)
- Jeffrey D Zampi
- University of Michigan Congenital Heart Center, C.S. Mott Children's Hospital, Ann Arbor, MI, USA
| | - Wendy Whiteside
- University of Michigan Congenital Heart Center, C.S. Mott Children's Hospital, Ann Arbor, MI, USA
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Solana-Gracia R, Rueda F, Betrián P, Gutiérrez-Larraya F, del Cerro MJ, Pan M, Alcíbar J, Coserría JF, Velasco JM, Zunzunegui JL. Registro español de implante percutáneo de la válvula pulmonar Melody en menores de 18 años. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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55
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Transcatheter versus surgical valve replacement for a failed pulmonary homograft in the Ross population. J Thorac Cardiovasc Surg 2018; 155:1434-1444. [DOI: 10.1016/j.jtcvs.2017.10.141] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/29/2017] [Accepted: 10/30/2017] [Indexed: 01/21/2023]
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Cabalka AK, Asnes JD, Balzer DT, Cheatham JP, Gillespie MJ, Jones TK, Justino H, Kim DW, Lung TH, Turner DR, McElhinney DB. Transcatheter pulmonary valve replacement using the melody valve for treatment of dysfunctional surgical bioprostheses: A multicenter study. J Thorac Cardiovasc Surg 2018; 155:1712-1724.e1. [DOI: 10.1016/j.jtcvs.2017.10.143] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/21/2017] [Accepted: 10/14/2017] [Indexed: 10/18/2022]
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Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4510] [Impact Index Per Article: 751.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
PURPOSE OF REVIEW The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. This review aims to summarize (1) the current state of the art for tPVR, (2) the expanding indications, and (3) the technological obstacles to optimizing tPVR. RECENT FINDINGS Since its introduction in 2000, more than ten thousands tPVR procedures have been performed worldwide. Although the indications for tPVR have been adapted earlier from those accepted for surgical intervention, they remain incompletely defined. The new imaging modalities give better assessment of cardiac anatomy and function and determine candidacy for the procedure. The procedure has been shown to be feasible and safe when performed in patients who received pulmonary conduit and or bioprosthetic valves between the right ventricle and the pulmonary artery. Fewer selected patients post trans-annular patch repair for tetralogy of Fallot may also be candidates for this technology. Size restrictions of the currently available valves limit deployment in the majority of patients post trans-annular patch repair. Newer valves and techniques are being developed that may help such patients. Refinements and further developments of this procedure hold promise for the extension of this technology to other patient populations.
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Ghobrial J, Aboulhosn J. Transcatheter valve replacement in congenital heart disease: the present and the future. Heart 2018; 104:1629-1636. [PMID: 29490935 DOI: 10.1136/heartjnl-2016-310898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Affiliation(s)
- Joanna Ghobrial
- Ahmanson/UCLA Adult Congenital Heart Disease Center, UCLA Medical Center, Los Angeles, California, USA.,Cleveland Clinic Adult Congenital Heart Disease Center, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Jamil Aboulhosn
- Ahmanson/UCLA Adult Congenital Heart Disease Center, UCLA Medical Center, Los Angeles, California, USA
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Kheiwa A, Divanji P, Mahadevan VS. Transcatheter pulmonary valve implantation: will it replace surgical pulmonary valve replacement? Expert Rev Cardiovasc Ther 2018; 16:197-207. [PMID: 29433351 DOI: 10.1080/14779072.2018.1435273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Right ventricular outflow tract (RVOT) dysfunction is a common hemodynamic challenge for adults with congenital heart disease (ACHD), including patients with repaired tetralogy of Fallot (TOF), truncus arteriosus (TA), and those who have undergone the Ross procedure for congenital aortic stenosis and the Rastelli repair for transposition of great vessels. Pulmonary valve replacement (PVR) has become one of the most common procedures performed for ACHD patients. Areas covered: Given the advances in transcatheter technology, we conducted a detailed review of the available studies addressing the indications for PVR, historical background, evolving technology, procedural aspects, and the future direction, with an emphasis on ACHD patients. Expert commentary: Transcatheter pulmonary valve implantation (TPVI) is widely accepted as an alternative to surgery to address RVOT dysfunction. However, current technology may not be able to adequately address a subset of patients with complex RVOT morphology. As the technology continues to evolve, new percutaneous valves will allow practitioners to apply the transcatheter approach in such patients. We expect that with the advancement in transcatheter technology, novel devices will be added to the TPVI armamentarium, making the transcatheter approach a feasible alternative for the majority of patients with RVOT dysfunction in the near future.
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Affiliation(s)
- Ahmed Kheiwa
- a Department of Medicine, Division of Cardiology , University of California San Francisco , San Francisco , CA , USA
| | - Punag Divanji
- a Department of Medicine, Division of Cardiology , University of California San Francisco , San Francisco , CA , USA
| | - Vaikom S Mahadevan
- a Department of Medicine, Division of Cardiology , University of California San Francisco , San Francisco , CA , USA.,b Adult Congenital Heart Disease Unit , Central Manchester University Hospitals, NHS Foundation Trust , Manchester , UK
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Solana-Gracia R, Rueda F, Betrián P, Gutiérrez-Larraya F, Del Cerro MJ, Pan M, Alcíbar J, Coserría JF, Velasco JM, Zunzunegui JL. Pediatrics Spanish Registry of Percutaneous Melody Pulmonary Valve Implantation in Patients Younger Than 18 Years. ACTA ACUST UNITED AC 2017; 71:283-290. [PMID: 29042164 DOI: 10.1016/j.rec.2017.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 07/06/2017] [Indexed: 11/15/2022]
Abstract
INTRODUCTION AND OBJECTIVES A decade has passed since the first Spanish percutaneous pulmonary Melody valve implant (PPVI) in March 2007. Our objective was to analyze its results in terms of valvular function and possible mid-term follow-up complications. METHODS Spanish retrospective descriptive multicenter analysis of Melody PPVI in patients < 18 years from the first implant in March 2007 until January 1, 2016. RESULTS Nine centers were recruited with a total of 81 PPVI in 77 pediatric patients, whose median age and weight were 13.3 years (interquartile range [IQR], 9.9-15.4) and 46kg (IQR, 27-63). The predominant cardiac malformation was tetralogy of Fallot (n = 27). Most of the valves were implanted on conduits, especially bovine xenografts (n = 31). The incidence of intraprocedure and acute complications was 6% and 8%, respectively (there were no periprocedural deaths). The median follow-up time was 2.4 years (IQR, 1.1-4.9). Infective endocarditis (IE) was diagnosed in 4 patients (5.6%), of which 3 required surgical valve explant. During follow-up, the EI-related mortality rate was 1.3%. At 5 years of follow-up, 80% ± 6.9% and 83% ± 6.1% of the patients were free from reintervention and pulmonary valve replacement. CONCLUSIONS Melody PPVI was safe and effective in pediatric patients with good short- and mid-term follow-up hemodynamic results. The incidence of IE during follow-up was relatively low but was still the main complication.
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Affiliation(s)
- Ruth Solana-Gracia
- Unidad de Cardiología Infantil, Hospital Universitario Infanta Leonor, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Fernando Rueda
- Unidad de Cardiología Infantil, Hospital Universitario A Coruña, A Coruña, Spain
| | - Pedro Betrián
- Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - María Jesús Del Cerro
- Servicio de Cardiología Infantil, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Manuel Pan
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Juan Alcíbar
- Servicio de Cardiología, Hospital Universitario de Cruces, Bilbao, Vizcaya, Spain
| | | | - José Manuel Velasco
- Instituto Pediátrico del Corazón, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José Luis Zunzunegui
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Unidad de Cardiología Infantil, Hospital Universitario Gregorio Marañón, Madrid, Spain
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Si MS. Open melody implant in a vascular graft-An alternative to the bioprosthetic valve? J Thorac Cardiovasc Surg 2017; 155:742-743. [PMID: 29029823 DOI: 10.1016/j.jtcvs.2017.09.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 09/09/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Ming-Sing Si
- Section of Pediatric Cardiovascular Surgery, Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
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63
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Shahanavaz S, Rockefeller T, Nicolas R, Balzer D. Fracturing a dysfunctional Edwards Perimount bioprosthetic valve to facilitate percutaneous valve-in-valve placement of SAPIEN 3 valve with modified delivery system. Catheter Cardiovasc Interv 2017; 91:81-85. [DOI: 10.1002/ccd.27237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/21/2017] [Accepted: 07/16/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Shabana Shahanavaz
- Division of Pediatric Cardiology, Department of Pediatrics; St. Louis Children's Hospital, Washington University School of Medicine; St. Louis Missouri
| | - Toby Rockefeller
- Division of Pediatric Cardiology, Department of Pediatrics; St. Louis Children's Hospital, Washington University School of Medicine; St. Louis Missouri
| | - Ramzi Nicolas
- Division of Pediatric Cardiology, Department of Pediatrics; St. Louis Children's Hospital, Washington University School of Medicine; St. Louis Missouri
| | - David Balzer
- Division of Pediatric Cardiology, Department of Pediatrics; St. Louis Children's Hospital, Washington University School of Medicine; St. Louis Missouri
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Abstract
PURPOSE OF REVIEW Our review is intended to provide readers with an overview of disease processes involving the pulmonic valve, highlighting recent outcome studies and guideline-based recommendations; with focus on the two most common interventions for treating pulmonic valve disease, balloon pulmonary valvuloplasty and pulmonic valve replacement. RECENT FINDINGS The main long-term sequelae of balloon pulmonary valvuloplasty, the gold standard treatment for pulmonic stenosis, remain pulmonic regurgitation and valvular restenosis. The balloon:annulus ratio is a major contributor to both, with high ratios resulting in greater degrees of regurgitation, and small ratios increasing risk for restenosis. Recent studies suggest that a ratio of approximately 1.2 may provide the most optimal results. Pulmonic valve replacement is currently the procedure of choice for patients with severe pulmonic regurgitation and hemodynamic sequelae or symptoms, yet it remains uncertain how it impacts long-term survival. Transcatheter pulmonic valve replacement is a rapidly evolving field and recent outcome studies suggest short and mid-term results at least equivalent to surgery. The Melody valve® was FDA approved for failing pulmonary surgical conduits in 2010 and for failing bioprosthetic surgical pulmonic valves in 2017 and has been extensively studied, whereas the Sapien XT valve®, offering larger diameters, was approved for failing pulmonary conduits in 2016 and has been less extensively studied. Patients with pulmonic valve disease deserve lifelong surveillance for complications. Transcatheter pulmonic valve replacement is a novel and attractive therapeutic option, but is currently only FDA approved for patients with failing pulmonary conduits or dysfunctional surgical bioprosthetic valves. New advances will undoubtedly increase the utilization of this rapidly expanding technology.
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Lluri G, Levi DS, Miller E, Hageman A, Sinha S, Sadeghi S, Reemtsen B, Laks H, Biniwale R, Salem M, Fishbein GA, Aboulhosn J. Incidence and outcome of infective endocarditis following percutaneous versus surgical pulmonary valve replacement. Catheter Cardiovasc Interv 2017; 91:277-284. [DOI: 10.1002/ccd.27312] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/31/2017] [Accepted: 08/05/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Gentian Lluri
- Department of Medicine; Division of Cardiology, David Geffen School of Medicine at UCLA, Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
| | - Daniel S. Levi
- Department of Medicine; Division of Cardiology, David Geffen School of Medicine at UCLA, Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
- Department of Pediatrics; Division of Cardiology, David Geffen School of Medicine at UCLA; Los Angeles California
| | - Emily Miller
- Department of Medicine; Division of Cardiology, David Geffen School of Medicine at UCLA, Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
| | - Abbie Hageman
- Department of Medicine; Division of Cardiology, David Geffen School of Medicine at UCLA, Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
| | - Sanjay Sinha
- Department of Pediatrics; Division of Cardiology, David Geffen School of Medicine at UCLA; Los Angeles California
| | - Soraya Sadeghi
- Department of Medicine; Division of Cardiology, David Geffen School of Medicine at UCLA, Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
| | - Brian Reemtsen
- Department of Cardiothoracic Surgery; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Hillel Laks
- Department of Cardiothoracic Surgery; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Reshma Biniwale
- Department of Cardiothoracic Surgery; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Morris Salem
- Department of Pediatrics; Division of Cardiology, Kaiser Permanente Los Angeles Medical Center; Los Angeles California
| | - Gregory A. Fishbein
- Department of Pathology and Laboratory Medicine; David Geffen School of Medicine at UCLA; Los Angeles California
| | - Jamil Aboulhosn
- Department of Medicine; Division of Cardiology, David Geffen School of Medicine at UCLA, Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
- Department of Pediatrics; Division of Cardiology, David Geffen School of Medicine at UCLA; Los Angeles California
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Cabalka AK, Hellenbrand WE, Eicken A, Kreutzer J, Gray RG, Bergersen L, Berger F, Armstrong AK, Cheatham JP, Zahn EM, McElhinney DB. Relationships Among Conduit Type, Pre-Stenting, and Outcomes in Patients Undergoing Transcatheter Pulmonary Valve Replacement in the Prospective North American and European Melody Valve Trials. JACC Cardiovasc Interv 2017; 10:1746-1759. [DOI: 10.1016/j.jcin.2017.05.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/30/2017] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
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Acute and Midterm Outcomes of Transcatheter Pulmonary Valve Replacement for Treatment of Dysfunctional Left Ventricular Outflow Tract Conduits in Patients With Aortopulmonary Transposition and a Systemic Right Ventricle. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.116.004730. [DOI: 10.1161/circinterventions.116.004730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 07/10/2017] [Indexed: 11/16/2022]
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68
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Torres AJ. Pre-Stenting and Melody Valve Stent Fracture. JACC Cardiovasc Interv 2017; 10:1760-1762. [DOI: 10.1016/j.jcin.2017.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/06/2017] [Indexed: 11/24/2022]
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70
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Choi EY, Song J, Lee H, Lee CH, Huh J, Kang IS, Yang JH, Jun TG. The effect of balloon valvuloplasty for bioprosthetic valve stenosis at pulmonary positions. CONGENIT HEART DIS 2017. [PMID: 28643385 DOI: 10.1111/chd.12507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Balloon dilatation of a bioprosthetic valve in the pulmonary position could be performed to delay valve replacement. We proposed to identify the long-term effectiveness of such a procedure. METHODS We reviewed the medical records of 49 patients who underwent balloon valvuloplasty between January 2000 and December 2015. The primary goal was to determine the time interval until the following surgical or catheter intervention. RESULTS The mean age at bioprosthetic valve insertion was 5.7 years old, and the mean age for ballooning was 11.7 years. The mean interval after pulmonary valve replacement was 71.6 months. The mean ratio of balloon size to valve size was 0.94. The pressure gradient through the pulmonary valve after balloon valvuloplasty was significantly improved (55.3 ± 18.5 mm Hg vs 33.8 ± 21.5 mm Hg, P < .001). There were no significant changes in pulmonary regurgitation and no serious adverse events. Patients had a mean freedom from re-intervention of 30.6 months after balloon valvuloplasty. The interval of freedom from re-intervention was affected only by the pressure gradient before balloon valvuloplasty and the patient age at insertion. The mean interval to re-intervention in patients with pressure gradients less than 48.5 mm Hg before ballooning was 46.0 months, which was significantly longer than for those with a higher gradient (18.7 months). CONCLUSION The effectiveness of this process may depend on the pressure gradient before ballooning and the patient age at valve insertion. It is possible that earlier valvuloplasty at pressure gradient not over 48.5mm Hg may have a benefit to delaying re-operation.
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Affiliation(s)
- Eun Young Choi
- Department of Pediatrics, Sejong General Hospital, Bucheon, Korea
| | - Jinyoung Song
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heirim Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Ha Lee
- Department of Thoracic Surgery, Sejong General Hospital, Bucheon, Korea
| | - Jun Huh
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - I-Seok Kang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hyuk Yang
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae Gook Jun
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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71
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Corno AF, Dawson AG, Bolger AP, Mimic B, Shebani SO, Skinner GJ, Speggiorin S. Trifecta St. Jude medical® aortic valve in pulmonary position. NANO REVIEWS & EXPERIMENTS 2017; 8:1299900. [PMID: 30410702 PMCID: PMC6167870 DOI: 10.1080/20022727.2017.1299900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/01/2017] [Accepted: 02/21/2017] [Indexed: 12/29/2022]
Abstract
Introduction: To evaluate an aortic pericardial valve for pulmonary valve (PV) regurgitation after repair of congenital heart defects. Methods: From July 2012 to June 2016 71 patients, mean age 24 ± 13 years (four to years) underwent PV implantation of aortic pericardial valve, mean interval after previous repair = 21 ± 10 years (two to 47 years). Previous surgery at mean age 3.2 ± 7.2 years (one day to 49 years): tetralogy of Fallot repair in 83% (59/71), pulmonary valvotomy in 11% (8/71), relief of right ventricular outflow tract (RVOT) obstruction in 6% (4/71). Pre-operative echocardiography and MRI showed severe PV regurgitation in 97% (69/71), moderate in 3% (2/71) with associated RVOT obstruction. MRI and knowledge-based reconstruction 3D volumetry (KBR-3D-volumetry) showed mean PV regurgitation = 42 ± 9% (20–58%), mean indexed RV end-diastolic volume = 169 ± 33 (130–265) ml m–2 BSA and mean ejection fraction (EF) = 46 ± 8% (33–61%). Cardio-pulmonary exercise showed mean peak O2/uptake = 24 ± 8 ml kg–1 min–1 (14–45 ml kg–1 min–1), predicted max O2/uptake 66 ± 17% (26–97%). Pre-operative NYHA class was I in 17% (12/71) patients, II in 70% (50/71) and III in 13% (9/71). Results: Mean cardio-pulmonary bypass duration was 95 ± 30ʹ (38–190ʹ), mean aortic cross-clamp in 23% (16/71) 46 ± 31ʹ (8–95ʹ), with 77% (55/71) implantations without aortic cross-clamp. Size of implanted PV: 21 mm in seven patients, 23 mm in 33, 25 mm in 23, and 27 mm in eight. The z-score of the implanted PV was −0.16 ± 0.80 (−1.6 to 2.5), effective orifice area indexed (for BSA) of native PV was 1.5 ± 0.2 (1.2 to –2.1) vs. implanted PV 1.2 ± 0.3 (0.76 to –2.5) (p = ns). In 76% (54/71) patients surgical RV modelling was associated. Mean duration of mechanical ventilation was 6 ± 5 h (0–26 h), mean ICU stay 21 ± 11 h (12–64 h), mean hospital stay 6 ± 3 days (three to 19 days). In mean follow-up = 25 ± 14 months (six to 53 months) there were no early/late deaths, no need for cardiac intervention/re-operation, no valve-related complications, thrombosis or endocarditis. Last echocardiography showed absent PV regurgitation in 87.3% (62/71) patients, trivial/mild degree in 11.3% (8/71), moderate degree in 1.45% (1/71), mean max peak velocity through RVOT 1.6 ± 0.4 (1.0–2.4) m s–1. Mean indexed RV end-diastolic volume at MRI/KBR-3D-volumetry was 96 ± 20 (63–151) ml m–2 BSA, lower than pre-operatively (p < 0.001), and mean EF = 55 ± 4% (49–61%), higher than pre-operatively (p < 0.05). Almost all patients (99% = 70/71) remain in NYHA class I, 1.45% = 1/71 in class II. Conclusion: (a) Aortic pericardial valve is implantable in PV position with an easy and reproducible surgical technique; (b) valve size adequate for patient BSA can be implanted with simultaneous RV remodelling; (c) medium-term outcomes are good with maintained PV function, RV dimensions significantly reduced and EF significantly improved; (d) adequate valve size will allow later percutaneous valve-in-valve implantation.
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Affiliation(s)
- Antonio F Corno
- Service of Paediatric and Congenital Cardiac Surgery, University Hospital Leicester, Glenfield Hospital, Leicester, UK
| | - Alan G Dawson
- Service of Paediatric and Congenital Cardiac Surgery, University Hospital Leicester, Glenfield Hospital, Leicester, UK
| | - Aidan P Bolger
- Service of Adult Congenital Cardiology, University Hospital Leicester, Glenfield Hospital, Leicester, UK
| | - Branco Mimic
- Service of Paediatric and Congenital Cardiac Surgery, University Hospital Leicester, Glenfield Hospital, Leicester, UK
| | - Suhair O Shebani
- Service of Paediatric Cardiology, University Hospital Leicester, Glenfield Hospital, Leicester, UK
| | - Gregory J Skinner
- Service of Paediatric Cardiology, University Hospital Leicester, Glenfield Hospital, Leicester, UK
| | - Simone Speggiorin
- Service of Paediatric and Congenital Cardiac Surgery, University Hospital Leicester, Glenfield Hospital, Leicester, UK
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72
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McRae ME, Coleman B, Atz TW, Kelechi TJ. Patient outcomes after transcatheter and surgical pulmonary valve replacement for pulmonary regurgitation in patients with repaired tetralogy of Fallot: A quasi-meta-analysis. Eur J Cardiovasc Nurs 2017; 16:539-553. [PMID: 28756698 DOI: 10.1177/1474515117696384] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Individuals with repaired tetralogy of Fallot develop pulmonary regurgitation that may cause symptoms (dyspnea, chest pain, palpitations, fatigue, presyncope, and syncope), impair functional capacity, and may affect health-related quality of life. Surgical pulmonary valve replacement is the gold standard of treatment although transcatheter pulmonary valve replacement is becoming more common. Patients want to know whether less invasive options are as good. AIMS This analysis aimed to examine the differences in surgical versus transcatheter pulmonary valve replacement effects in terms of physiological/biological variables, symptoms, functional status and health-related quality of life. METHODS This quasi-meta-analysis included 85 surgical and 47 transcatheter pulmonary valve replacement studies published between 1995-2016. RESULTS In terms of physiological/biological variables, both surgical and transcatheter pulmonary valve replacement improved pulmonary regurgitation and systolic and diastolic right ventricular volume indices but not heart function. In the left heart, only surgical pulmonary valve replacement improved heart function. Only transcatheter pulmonary valve replacement improved left ventricular end-diastolic indices and neither improved endsystolic indices. Only surgery has been demonstrated to decrease QRS duration but there is little evidence of arrhythmia reduction. Symptom change is poorly documented. Functional class improves but exercise capacity generally does not. Some aspects of health-related quality of life improve with surgery and in one small transcatheter pulmonary valve replacement study. CONCLUSION Transcatheter and surgical pulmonary valve replacement compare favorably for heart remodeling. Exercise capacity does not change with either technique. Health-related quality of life improves after surgical pulmonary valve replacement. There are numerous gaps in documentation of changes in arrhythmias and symptoms.
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Affiliation(s)
- Marion E McRae
- 1 Medical University of South Carolina, USA.,2 Guerin Family Congenital Heart Program, Cedars-Sinai Medical Center, USA.,3 David Geffen School of Medicine, University of California at Los Angeles
| | - Bernice Coleman
- 4 Nursing Research Department, Cedars-Sinai Medical Center, USA
| | - Teresa W Atz
- 5 College of Medicine, Medical University of South Carolina, USA
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Callahan R, Bergersen L, Baird CW, Porras D, Esch JJ, Lock JE, Marshall AC. Mechanism of valve failure and efficacy of reintervention through catheterization in patients with bioprosthetic valves in the pulmonary position. Ann Pediatr Cardiol 2017; 10:11-17. [PMID: 28163423 PMCID: PMC5241839 DOI: 10.4103/0974-2069.197049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Surgical and transcatheter bioprosthetic valves (BPVs) in the pulmonary position in patients with congenital heart disease may ultimately fail and undergo transcatheter reintervention. Angiographic assessment of the mechanism of BPV failure has not been previously described. AIMS The aim of this study was to determine the mode of BPV failure (stenosis/regurgitation) requiring transcatheter reintervention and to describe the angiographic characteristics of the failed BPVs and report the types and efficacy of reinterventions. MATERIALS AND METHODS This is a retrospective single-center review of consecutive patients who previously underwent pulmonary BPV placement (surgical or transcatheter) and subsequently underwent percutaneous reintervention from 2005 to 2014. RESULTS Fifty-five patients with surgical (41) and transcutaneous pulmonary valve (TPV) (14) implantation of BPVs underwent 66 catheter reinterventions. The surgically implanted valves underwent fifty reinterventions for indications including 16 for stenosis, seven for regurgitation, and 27 for both, predominantly associated with leaflet immobility, calcification, and thickening. Among TPVs, pulmonary stenosis (PS) was the exclusive failure mode, mainly due to loss of stent integrity (10) and endocarditis (4). Following reintervention, there was a reduction of right ventricular outflow tract gradient from 43 ± 16 mmHg to 16 ± 10 mmHg (P < 0.001) and RVp/AO ratio from 0.8 ± 0.2 to 0.5 ± 0.2 (P < 0.001). Reintervention with TPV placement was performed in 45 (82%) patients (34 surgical, 11 transcatheter) with no significant postintervention regurgitation or paravalvular leak. CONCLUSION Failing surgically implanted BPVs demonstrate leaflet calcification, thickness, and immobility leading to PS and/or regurgitation while the mechanism of TPV failure in the short- to mid-term is stenosis, mainly from loss of stent integrity. This can be effectively treated with a catheter-based approach, predominantly with the valve-in-valve technique.
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Affiliation(s)
- Ryan Callahan
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Lisa Bergersen
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Christopher W Baird
- Department of Cardiac Surgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Diego Porras
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Jesse J Esch
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - James E Lock
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Audrey C Marshall
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
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Affiliation(s)
- Doff B. McElhinney
- From the Lucille Packard Children’s Hospital, Stanford University School of Medicine, Palo Alto, CA
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Kuo JA, Feezel AA, Putnam TN, Schutte DA. Melody valve implantation within freestyle stentless porcine aortic heterograft. Catheter Cardiovasc Interv 2016; 89:1224-1230. [DOI: 10.1002/ccd.26862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 10/19/2016] [Accepted: 10/23/2016] [Indexed: 11/10/2022]
Affiliation(s)
- James A. Kuo
- Cook Children's Medical Center; Fort Worth Texas
| | - Ashlea A. Feezel
- University of North Texas Health Sciences Center; Fort Worth Texas
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Tarzia P, Conforti E, Giamberti A, Varrica A, Giugno L, Micheletti A, Negura D, Piazza L, Saracino A, Carminati M, Chessa M. Percutaneous management of failed bioprosthetic pulmonary valves in patients with congenital heart defects. J Cardiovasc Med (Hagerstown) 2016; 18:430-435. [PMID: 27828833 DOI: 10.2459/jcm.0000000000000486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS We reviewed our center experience in the field of transcatheter pulmonary valve-in-valve implantation (TPViV), that is emerging as a treatment option for patients with pulmonary bioprosthetic valve (BPV) dysfunction. METHODS Between April 2008 and September 2015, a total of six patients with congenital heart disease (four men) underwent TPViV due to stenosis of preexisting BPV. Four patients received a Melody Medtronic Transcatheter Pulmonary Valve and two an Edward Sapien Valve. RESULTS No procedural-related complications occurred. After valve implantation, right ventricular systolic pressure (RVSP, 80.5 ± 25.3-41.2 ± 8.35 mmHg, P < 0.05), right ventricular outflow tract (RVOT) gradient (55.3 ± 23.4-10.6 ± 3.8 mmHg, P < 0.05), and RVSP-to-aortic pressure (0.75 ± 0.21-0.38 ± 0.21, P = 0.01) fell significantly. Echocardiograms at follow-up revealed a significant reduction in estimated RVSP (88.7 ± 22-21.7 ± 4.7 mmHg, P < 0.05), in RVOT (76.2 ± 17.9-25.7 ± 6.1 mmHg, P = 0.005), and in mean RVOT (40.7 ± 9.9-15.5 ± 4.8 mmHg, P < 0.05) gradients. Cardiac magnetic resonance showed no significant change in biventricular dimensions and function. Symptomatic patients reported improvement of symptoms, although cardiopulmonary exercise did not show any significant differences. CONCLUSION TPViV is an effective and well tolerated treatment for BPV dysfunction, improving freedom from surgical reintervention. Long-term studies will redefine the management of dysfunctional RVOT, either native or surrogate.
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Affiliation(s)
- Pierpaolo Tarzia
- aPediatric and Adult Congenital Heart Centre, IRCCS, Policlinico San Donato, University Hospital, Via Morandi, 30, San Donato M.se, Milan 20097, Italy bInstitute of Cardiology, Catholic University of the Sacred Heart, IRCCS Policlinico Universitario 'Agostino Gemelli', Rome, Italy
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Schoonbeek RC, Takebayashi S, Aoki C, Shimaoka T, Harris MA, Fu GL, Kim TS, Dori Y, McGarvey J, Litt H, Bouma W, Zsido G, Glatz AC, Rome JJ, Gorman RC, Gorman JH, Gillespie MJ. Implantation of the Medtronic Harmony Transcatheter Pulmonary Valve Improves Right Ventricular Size and Function in an Ovine Model of Postoperative Chronic Pulmonary Insufficiency. Circ Cardiovasc Interv 2016; 9:CIRCINTERVENTIONS.116.003920. [PMID: 27662847 DOI: 10.1161/circinterventions.116.003920] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 08/26/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary insufficiency is the nexus of late morbidity and mortality after transannular patch repair of tetralogy of Fallot. This study aimed to establish the feasibility of implantation of the novel Medtronic Harmony transcatheter pulmonary valve (hTPV) and to assess its effect on pulmonary insufficiency and ventricular function in an ovine model of chronic postoperative pulmonary insufficiency. METHODS AND RESULTS Thirteen sheep underwent baseline cardiac magnetic resonance imaging, surgical pulmonary valvectomy, and transannular patch repair. One month after transannular patch repair, the hTPV was implanted, followed by serial magnetic resonance imaging and computed tomography imaging at 1, 5, and 8 month(s). hTPV implantation was successful in 11 animals (85%). There were 2 procedural deaths related to ventricular fibrillation. Seven animals survived the entire follow-up protocol, 5 with functioning hTPV devices. Two animals had occlusion of hTPV with aneurysm of main pulmonary artery. A strong decline in pulmonary regurgitant fraction was observed after hTPV implantation (40.5% versus 8.3%; P=0.011). Right ventricular end diastolic volume increased by 49.4% after transannular patch repair (62.3-93.1 mL/m2; P=0.028) but was reversed to baseline values after hTPV implantation (to 65.1 mL/m2 at 8 months, P=0.045). Both right ventricular ejection fraction and left ventricular ejection fraction were preserved after hTPV implantation. CONCLUSIONS hTPV implantation is feasible, significantly reduces pulmonary regurgitant fraction, facilitates right ventricular volume improvements, and preserves biventricular function in an ovine model of chronic pulmonary insufficiency. This percutaneous strategy could potentially offer an alternative for standard surgical pulmonary valve replacement in dilated right ventricular outflow tracts, permitting lower risk, nonsurgical pulmonary valve replacement in previously prohibitive anatomies.
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Affiliation(s)
- Rosanne C Schoonbeek
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Satoshi Takebayashi
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Chikashi Aoki
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Toru Shimaoka
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Matthew A Harris
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Gregory L Fu
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Timothy S Kim
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Yoav Dori
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Jeremy McGarvey
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Harold Litt
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Wobbe Bouma
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Gerald Zsido
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Andrew C Glatz
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Jonathan J Rome
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Robert C Gorman
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Joseph H Gorman
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.)
| | - Matthew J Gillespie
- From the Gorman Cardiovascular Research Group, Department of Surgery, The Children's Hospital of Philadelphia, PA (R.C.S., S.T., C.A., T.S., J.M., W.B., G.Z., R.C.G., J.H.G., M.J.G.); Department of Cardiology (M.A.H., G.L.F., T.S.K, Y.D., A.C.G, J.J.R., M.J.G.) and Department Radiology (H.L.), Perelman School of Medicine, University of Pennsylvania, Philadelphia; and Department of Cardiothoracic Surgery, University Medical Center Groningen, University of Groningen, the Netherlands (R.C.S., W.B.).
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Abstract
PURPOSE OF REVIEW Transcatheter pulmonary valve replacement has only been both approved and widely available for most congenital heart disease centers for a few years; its use and familiarity for interventionalists have greatly expanded our knowledge of its applicability to a multitude of clinical situations. Expanded worldwide use and longer time from implant have both served to better understand procedural limits and uncommon late adverse events. RECENT FINDINGS Although currently approved for implantation in the USA only in dysfunctional and circumferential right ventricle to pulmonary artery conduits, with expanded experience operators have been able to adapt the delivery of this valve in a large number of additional clinical scenarios. Rare technical limitations of the procedure, most importantly coronary compression, are now being better defined. Although not frequent, a significant number of infective endocarditis episodes have been reported, but more recently several studies have deepened our understanding of this late adverse event for the most commonly implanted transcatheter pulmonary valve prosthesis. SUMMARY Expanded and widened use has extended our understanding of who may benefit from transcatheter pulmonary valve implantation (TPVI), the current limits of TPVI, and uncommon but important late issues following TPVI.
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Lunze FI, Hasan BS, Gauvreau K, Brown DW, Colan SD, McElhinney DB. Progressive intermediate-term improvement in ventricular and atrioventricular interaction after transcatheter pulmonary valve replacement in patients with right ventricular outflow tract obstruction. Am Heart J 2016; 179:87-98. [PMID: 27595683 DOI: 10.1016/j.ahj.2016.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 05/17/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Relief of postoperative right ventricular outflow tract (RVOT) obstruction with transcatheter pulmonary valve replacement (TPVR) results in functional improvement in the short term which we investigated at baseline (BL), early follow-up (FU), and midterm FU after TPVR. METHODS Echocardiography and cardiopulmonary exercise testing were performed at BL and at early (median 6 months) and midterm FU (median 2.5years) after TPVR. RESULTS Patients with RVOT obstruction (n=22, median age 17years) were studied. The max RVOT Doppler gradient fell from BL to early FU (60±24 to 26±8mm Hg, P<.001). Left ventricular (LV) end-diastolic and stroke volume increased at early FU (both P<.001) without further change, whereas LV ejection fraction improved throughout FU (P<.001). LV end-systolic and diastolic eccentricity (leftward septal displacement) improved early (both P≤.003), and end-diastolic eccentricity improved further at midterm FU (P=.02). Furthermore, whereas mitral inflow A wave velocity increased (P=.003), the LV A' velocity declined early (P=.007) without further change at midterm. RV systolic and early diastolic function was impaired at BL. Whereas RV strain improved partially at early and midterm FU (P≤.02), RV E' velocity did not improve throughout FU. Mildly impaired LV strain at BL fully recovered by midterm FU (P≤.002). Peak oxygen uptake improved at early and midterm FU (all P≤.003). CONCLUSIONS Patients with RVOT obstruction had biventricular systolic and diastolic dysfunction at BL. Relieving RVOT obstruction with TPVR reduced adverse ventricular and compensatory atrioventricular interaction, resulting in progressive biventricular functional improvement and remodeling at early and midterm FU.
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Lee C, Lee CH, Kwak JG. Polytetrafluoroethylene Bicuspid Pulmonary Valve Replacement: A 5-Year Experience in 119 Patients With Congenital Heart Disease. Ann Thorac Surg 2016; 102:163-9. [DOI: 10.1016/j.athoracsur.2016.01.056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/06/2015] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
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Nozynska J, Stiller B, Grohmann J. Management of a dissection of matrix P right ventricular-to-pulmonary artery conduit by implanting two pre-stents and a melody valve. Catheter Cardiovasc Interv 2016; 91:E64-E67. [PMID: 27246262 DOI: 10.1002/ccd.26581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 04/21/2016] [Indexed: 11/05/2022]
Abstract
Reconstructing the right ventricular outflow tract and pulmonary valve via a bovine-derived valve conduit such as Matrix-P-Xenograft is a common surgical repair technique for pulmonary atresia and ventricular septal defect. After conduit degeneration due to calcification or aneurysmal dilatation, percutaneous transvenous stenting of the right ventricular outflow tract followed by pulmonary valve implantation has become the standard interventional treatment. Applied to stenotic conduits, the method is considered safe and effective. An important but seldom-reported problem is graft failure related to the formation of a Matrix membrane due to inflammation and fibrosis inside the xenograft, which can cause serious problems when dissection and rupture occur during transcatheter intervention. The torn pseudomembrane may cause the complete obstruction of both pulmonary arteries, resulting in a life-threatening situation requiring rapid intervention, as in this case presentation. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Joanna Nozynska
- Department of Congenital Heart Defects and Pediatric Cardiology, Heart Centre, University of Freiburg, Freiburg, Germany
| | - Brigitte Stiller
- Department of Congenital Heart Defects and Pediatric Cardiology, Heart Centre, University of Freiburg, Freiburg, Germany
| | - Jochen Grohmann
- Department of Congenital Heart Defects and Pediatric Cardiology, Heart Centre, University of Freiburg, Freiburg, Germany
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Levi DS, Sinha S, Salem MM, Aboulhosn JA. Transcatheter native pulmonary valve and tricuspid valve replacement with the sapien XT: Initial experience and development of a new delivery platform. Catheter Cardiovasc Interv 2016; 88:434-43. [DOI: 10.1002/ccd.26398] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 12/15/2015] [Accepted: 12/21/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Daniel S. Levi
- Department of Pediatrics, Division of Cardiology; UCLA Mattel Children's Hospital; Los Angeles California
| | - Sanjay Sinha
- Department of Pediatrics, Division of Cardiology; UCLA Mattel Children's Hospital; Los Angeles California
| | - Morris M. Salem
- Department of Pediatrics, Division of Cardiology; Kaiser Permanente; Los Angeles California
| | - Jamil A. Aboulhosn
- Department of Medicine; Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA; Los Angeles California
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Lindsay I, Aboulhosn J, Salem M, Levi D. Aortic root compression during transcatheter pulmonary valve replacement. Catheter Cardiovasc Interv 2016; 88:814-821. [DOI: 10.1002/ccd.26547] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 01/07/2016] [Accepted: 03/12/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Ian Lindsay
- The Division of Pediatric Cardiology, UCLA Medical Center; University of California at Los Angeles; California
- Ahmanson-UCLA Adult Congenital Heart Disease Center; University of California at Los Angeles; Los Angeles California
| | - Jamil Aboulhosn
- The Division of Pediatric Cardiology, UCLA Medical Center; University of California at Los Angeles; California
- Ahmanson-UCLA Adult Congenital Heart Disease Center; University of California at Los Angeles; Los Angeles California
| | - Morris Salem
- Department of Pediatrics, Division of Cardiology, Kaiser Permanente; Los Angeles California
| | - Daniel Levi
- The Division of Pediatric Cardiology, UCLA Medical Center; University of California at Los Angeles; California
- Ahmanson-UCLA Adult Congenital Heart Disease Center; University of California at Los Angeles; Los Angeles California
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McElhinney DB, Cabalka AK, Aboulhosn JA, Eicken A, Boudjemline Y, Schubert S, Himbert D, Asnes JD, Salizzoni S, Bocks ML, Cheatham JP, Momenah TS, Kim DW, Schranz D, Meadows J, Thomson JD, Goldstein BH, Crittendon I, Fagan TE, Webb JG, Horlick E, Delaney JW, Jones TK, Shahanavaz S, Moretti C, Hainstock MR, Kenny DP, Berger F, Rihal CS, Dvir D. Transcatheter Tricuspid Valve-in-Valve Implantation for the Treatment of Dysfunctional Surgical Bioprosthetic Valves. Circulation 2016; 133:1582-93. [DOI: 10.1161/circulationaha.115.019353] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/19/2016] [Indexed: 11/16/2022]
Abstract
Background—
Off-label use of transcatheter aortic and pulmonary valve prostheses for tricuspid valve-in-valve implantation (TVIV) within dysfunctional surgical tricuspid valve (TV) bioprostheses has been described in small reports.
Methods and Results—
An international, multicenter registry was developed to collect data on TVIV cases. Patient-related factors, procedural details and outcomes, and follow-up data were analyzed. Valve-in-ring or heterotopic TV implantation procedures were not included. Data were collected on 156 patients with bioprosthetic TV dysfunction who underwent catheterization with planned TVIV. The median age was 40 years, and 71% of patients were in New York Heart Association class III or IV. Among 152 patients in whom TVIV was attempted with a Melody (n=94) or Sapien (n=58) valve, implantation was successful in 150, with few serious complications. After TVIV, both the TV inflow gradient and tricuspid regurgitation grade improved significantly. During follow-up (median, 13.3 months), 22 patients died, 5 within 30 days; all 22 patients were in New York Heart Association class III or IV, and 9 were hospitalized before TVIV. There were 10 TV reinterventions, and 3 other patients had significant recurrent TV dysfunction. At follow-up, 77% of patients were in New York Heart Association class I or II (
P
<0.001 versus before TVIV). Outcomes did not differ according to surgical valve size or TVIV valve type.
Conclusions—
TVIV with commercially available transcatheter prostheses is technically and clinically successful in patients of various ages across a wide range of valve size. Although preimplantation clinical status was associated with outcome, many patients in New York Heart Association class III or IV at baseline improved. TVIV should be considered a viable option for treatment of failing TV bioprostheses.
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Affiliation(s)
- Doff B. McElhinney
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Allison K. Cabalka
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Jamil A. Aboulhosn
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Andreas Eicken
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Younes Boudjemline
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Stephan Schubert
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Dominique Himbert
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Jeremy D. Asnes
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Stefano Salizzoni
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Martin L. Bocks
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - John P. Cheatham
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Tarek S. Momenah
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Dennis W. Kim
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Dietmar Schranz
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Jeffery Meadows
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - John D.R. Thomson
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Bryan H. Goldstein
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Ivory Crittendon
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Thomas E. Fagan
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - John G. Webb
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Eric Horlick
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Jeffrey W. Delaney
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Thomas K. Jones
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Shabana Shahanavaz
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Carolina Moretti
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Michael R. Hainstock
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Damien P. Kenny
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Felix Berger
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Charanjit S. Rihal
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
| | - Danny Dvir
- From Stanford University, Palo Alto, CA (D.B.M.); Mayo Clinic, Rochester, MN (A.K.C., C.J.R.); University of California Los Angeles (J.A.A.); German Heart Centre, Munich, Germany (A.E.); Necker Enfants Malades Hospital, Paris, France (Y.B.); Deutsches Herzzentrum Berlin, Germany (S. Schubert, B.G.); Bichat Hospital, Paris, France (D.H.); Yale University, New Haven, CT (J.D.A.); Città della Salute e della Scienza, Molinette, Torino, Italy (S. Salizzoni); University of Michigan, Ann Arbor (M.L.B.)
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Abstract
There is a growing appreciation for the adverse long-term impact of right-sided valvular dysfunction in patients with congenital heart disease. Although right-sided valvular stenosis and/or regurgitation is often better tolerated than left-sided valvular dysfunction in the short and intermediate term, the long-term consequences are numerous and include, but are not limited to, arrhythmias, heart failure, and multi-organ dysfunction. Surgical right-sided valve interventions have been performed for many decades, but the comorbidities associated with multiple surgeries are a concern. Transcatheter right-sided valve replacement is safe and effective and is being performed at an increasing number of centers around the world. It offers an alternative to traditional surgical techniques and may potentially alter the decision making process whereby valvular replacement is performed prior to the development of long-term sequelae of right-sided valvular dysfunction.
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86
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Dunne B, Suthers E, Xiao P, Xiao J, Litton E, Andrews D. Medium-term outcomes after pulmonary valve replacement with the Freestyle valve for congenital heart disease: a case series. Eur J Cardiothorac Surg 2016; 49:e105-11. [DOI: 10.1093/ejcts/ezw024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/29/2015] [Indexed: 11/12/2022] Open
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87
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Lee C, Lee CH, Kwak JG. Outcomes of redo pulmonary valve replacement for bioprosthetic pulmonary valve failure in 61 patients with congenital heart disease. Eur J Cardiothorac Surg 2016; 50:470-5. [DOI: 10.1093/ejcts/ezw037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 01/25/2016] [Indexed: 11/12/2022] Open
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Ansari MM, Cardoso R, Garcia D, Sandhu S, Horlick E, Brinster D, Martucci G, Piazza N. Percutaneous Pulmonary Valve Implantation. J Am Coll Cardiol 2015; 66:2246-2255. [DOI: 10.1016/j.jacc.2015.09.055] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 09/22/2015] [Indexed: 10/22/2022]
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89
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Asnes J, Hellenbrand WE. Evaluation of the Melody transcatheter pulmonary valve and Ensemble delivery system for the treatment of dysfunctional right ventricle to pulmonary artery conduits. Expert Rev Med Devices 2015; 12:653-65. [DOI: 10.1586/17434440.2015.1102050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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90
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Cardoso R, Ansari M, Garcia D, Sandhu S, Brinster D, Piazza N. Prestenting for prevention of melody valve stent fractures: A systematic review and meta-analysis. Catheter Cardiovasc Interv 2015; 87:534-9. [PMID: 26481871 DOI: 10.1002/ccd.26235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 08/24/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION The role of right ventricular outflow tract (RVOT) prestenting in the prevention of Melody valve stent fractures (SFs) is not well defined. We aimed to perform a systematic review and meta-analysis comparing the incidence of SF in Melody valve transcatheter pulmonary implants with and without prestenting. METHODS PubMed, EMBASE, and Cochrane Central were searched for studies that reported the incidence of SF in Melody valve transcatheter pulmonary implants stratified by the presence or absence of RVOT prestenting. Subgroup analyses were performed for (1) SF associated with a loss of stent integrity and (2) SF requiring reintervention. RESULTS Five studies and 360 patients were included, of whom 207 (57.5%) received prestenting. Follow-up ranged from 15 to 30 months. SF were significantly reduced in the prestenting group (16.7%) when compared to no prestenting (33.5%) (odds-ratio [OR] 0.39; 95%CI 0.22-0.69). Patients who received prestenting also had a lower incidence of (1) SF associated with loss of stent integrity (OR 0.16; 95%CI 0.05-0.48) and (2) SF requiring reintervention (OR 0.15; 95%CI 0.02-0.91). CONCLUSION Our findings suggest that stenting of the RVOT prior to Melody valve implantation is associated with a reduction in the incidence of SF and fracture-related reinterventions.
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Affiliation(s)
- Rhanderson Cardoso
- Division of Cardiology Department of Medicine, University of Miami, Jackson, Memorial Hospital, Miami, Florida
| | - Mohammad Ansari
- Division of Structural Heart Diseases Department of Cardiothoracic Surgery, Lenox Hill Heart and Vascular Institute, New York, New York
| | - Daniel Garcia
- Department of Cardiology, Ochsner Medical Center, New Orleans, Louisiana
| | - Satinder Sandhu
- Division of Cardiology Department of Medicine, University of Miami, Jackson, Memorial Hospital, Miami, Florida
| | - Derek Brinster
- Department of Cardiothoracic Surgery, Lenox Hill Heart and Vascular Institute, New York, New York
| | - Nicolo Piazza
- Division of Cardiology Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
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91
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Transcatheter Advances in the Treatment of Adult and Congenital Valvular Heart Disease. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2015; 17:52. [DOI: 10.1007/s11936-015-0411-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bhatt AB, Foster E, Kuehl K, Alpert J, Brabeck S, Crumb S, Davidson WR, Earing MG, Ghoshhajra BB, Karamlou T, Mital S, Ting J, Tseng ZH. Congenital Heart Disease in the Older Adult. Circulation 2015; 131:1884-931. [DOI: 10.1161/cir.0000000000000204] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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93
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Rothman A, Galindo A, Evans WN. Implantation of a 29 mm sapien XT valve in a pediatric patient with an unstented right ventricular outflow tract. Catheter Cardiovasc Interv 2015; 86:1087-91. [DOI: 10.1002/ccd.25968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 03/30/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Abraham Rothman
- Children's Heart Center, Pediatric Cardiology Division; Las Vegas Nevada
- School of Medicine; Department of Pediatrics, Division of Cardiology; University of Nevada; Las Vegas Nevada
| | - Alvaro Galindo
- Children's Heart Center, Pediatric Cardiology Division; Las Vegas Nevada
- School of Medicine; Department of Pediatrics, Division of Cardiology; University of Nevada; Las Vegas Nevada
| | - William N. Evans
- Children's Heart Center, Pediatric Cardiology Division; Las Vegas Nevada
- School of Medicine; Department of Pediatrics, Division of Cardiology; University of Nevada; Las Vegas Nevada
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Cheatham JP, Hellenbrand WE, Zahn EM, Jones TK, Berman DP, Vincent JA, McElhinney DB. Clinical and hemodynamic outcomes up to 7 years after transcatheter pulmonary valve replacement in the US melody valve investigational device exemption trial. Circulation 2015; 131:1960-70. [PMID: 25944758 DOI: 10.1161/circulationaha.114.013588] [Citation(s) in RCA: 223] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 03/23/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Studies of transcatheter pulmonary valve (TPV) replacement with the Melody valve have demonstrated good short-term outcomes, but there are no published long-term follow-up data. METHODS AND RESULTS The US Investigational Device Exemption trial prospectively enrolled 171 pediatric and adult patients (median age, 19 years) with right ventricular outflow tract conduit obstruction or regurgitation. The 148 patients who received and were discharged with a TPV were followed up annually according to a standardized protocol. During a median follow-up of 4.5 years (range, 0.4-7 years), 32 patients underwent right ventricular outflow tract reintervention for obstruction (n=27, with stent fracture in 22), endocarditis (n=3, 2 with stenosis and 1 with pulmonary regurgitation), or right ventricular dysfunction (n=2). Eleven patients had the TPV explanted as an initial or second reintervention. Five-year freedom from reintervention and explantation was 76±4% and 92±3%, respectively. A conduit prestent and lower discharge right ventricular outflow tract gradient were associated with longer freedom from reintervention. In the 113 patients who were alive and reintervention free, the follow-up gradient (median, 4.5 years after implantation) was unchanged from early post-TPV replacement, and all but 1 patient had mild or less pulmonary regurgitation. Almost all patients were in New York Heart Association class I or II. More severely impaired baseline spirometry was associated with a lower likelihood of improvement in exercise function after TPV replacement. CONCLUSIONS TPV replacement with the Melody valve provided good hemodynamic and clinical outcomes up to 7 years after implantation. Primary valve failure was rare. The main cause of TPV dysfunction was stenosis related to stent fracture, which was uncommon once prestenting became more widely adopted. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00740870.
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Affiliation(s)
- John P Cheatham
- From Division of Cardiology, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus (J.P.C., D.P.B.); Division of Pediatric Cardiology, Yale University, New Haven, CT (W.E.H.); Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (E.M.Z.); Division of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (T.K.J.); Division of Cardiology, Miami Children's Hospital, FL (D.P.B.); Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (J.A.V.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA (D.B.M.).
| | - William E Hellenbrand
- From Division of Cardiology, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus (J.P.C., D.P.B.); Division of Pediatric Cardiology, Yale University, New Haven, CT (W.E.H.); Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (E.M.Z.); Division of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (T.K.J.); Division of Cardiology, Miami Children's Hospital, FL (D.P.B.); Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (J.A.V.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA (D.B.M.)
| | - Evan M Zahn
- From Division of Cardiology, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus (J.P.C., D.P.B.); Division of Pediatric Cardiology, Yale University, New Haven, CT (W.E.H.); Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (E.M.Z.); Division of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (T.K.J.); Division of Cardiology, Miami Children's Hospital, FL (D.P.B.); Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (J.A.V.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA (D.B.M.)
| | - Thomas K Jones
- From Division of Cardiology, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus (J.P.C., D.P.B.); Division of Pediatric Cardiology, Yale University, New Haven, CT (W.E.H.); Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (E.M.Z.); Division of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (T.K.J.); Division of Cardiology, Miami Children's Hospital, FL (D.P.B.); Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (J.A.V.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA (D.B.M.)
| | - Darren P Berman
- From Division of Cardiology, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus (J.P.C., D.P.B.); Division of Pediatric Cardiology, Yale University, New Haven, CT (W.E.H.); Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (E.M.Z.); Division of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (T.K.J.); Division of Cardiology, Miami Children's Hospital, FL (D.P.B.); Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (J.A.V.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA (D.B.M.)
| | - Julie A Vincent
- From Division of Cardiology, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus (J.P.C., D.P.B.); Division of Pediatric Cardiology, Yale University, New Haven, CT (W.E.H.); Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (E.M.Z.); Division of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (T.K.J.); Division of Cardiology, Miami Children's Hospital, FL (D.P.B.); Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (J.A.V.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA (D.B.M.)
| | - Doff B McElhinney
- From Division of Cardiology, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus (J.P.C., D.P.B.); Division of Pediatric Cardiology, Yale University, New Haven, CT (W.E.H.); Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (E.M.Z.); Division of Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (T.K.J.); Division of Cardiology, Miami Children's Hospital, FL (D.P.B.); Division of Pediatric Cardiology, Columbia University Medical Center, New York, NY (J.A.V.); and Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA (D.B.M.)
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Dunne B, Xiao A, Litton E, Andrews D. Mechanical Prostheses for Right Ventricular Outflow Tract Reconstruction: A Systematic Review and Meta-Analysis. Ann Thorac Surg 2015; 99:1841-7. [DOI: 10.1016/j.athoracsur.2014.11.058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 11/17/2014] [Accepted: 11/24/2014] [Indexed: 11/30/2022]
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Wagner R, Daehnert I, Lurz P. Percutaneous pulmonary and tricuspid valve implantations: An update. World J Cardiol 2015; 7:167-177. [PMID: 25914786 PMCID: PMC4404372 DOI: 10.4330/wjc.v7.i4.167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 01/08/2015] [Accepted: 02/12/2015] [Indexed: 02/06/2023] Open
Abstract
The field of percutaneous valvular interventions is one of the most exciting and rapidly developing within interventional cardiology. Percutaneous procedures focusing on aortic and mitral valve replacement or interventional treatment as well as techniques of percutaneous pulmonary valve implantation have already reached worldwide clinical acceptance and routine interventional procedure status. Although techniques of percutaneous pulmonary valve implantation have been described just a decade ago, two stent-mounted complementary devices were successfully introduced and more than 3000 of these procedures have been performed worldwide. In contrast, percutaneous treatment of tricuspid valve dysfunction is still evolving on a much earlier level and has so far not reached routine interventional procedure status. Taking into account that an “interdisciplinary challenging”, heterogeneous population of patients previously treated by corrective, semi-corrective or palliative surgical procedures is growing inexorably, there is a rapidly increasing need of treatment options besides redo-surgery. Therefore, the review intends to reflect on clinical expansion of percutaneous pulmonary and tricuspid valve procedures, to update on current devices, to discuss indications and patient selection criteria, to report on clinical results and finally to consider future directions.
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98
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Finch W, Levi DS, Salem M, Hageman A, Aboulhosn J. Transcatheter melody valve placement in large diameter bioprostheses and conduits: What is the optimal “Landing zone”? Catheter Cardiovasc Interv 2015; 86:E217-23. [DOI: 10.1002/ccd.25922] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 03/08/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Will Finch
- Division of Cardiology; Department of Medicine, David Geffen School of Medicine at UCLA; Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
| | - Daniel S. Levi
- Division of Cardiology; Department of Medicine, David Geffen School of Medicine at UCLA; Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
- Division of Cardiology, Department of Pediatrics, David Geffen School of Medicine at UCLA; Los Angeles California
| | - Morris Salem
- Division of Cardiology, Department of Pediatrics; Kaiser Permanente Los Angeles Medical Center; Los Angeles California
| | - Abbie Hageman
- Division of Cardiology; Department of Medicine, David Geffen School of Medicine at UCLA; Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
| | - Jamil Aboulhosn
- Division of Cardiology; Department of Medicine, David Geffen School of Medicine at UCLA; Ahmanson/UCLA Adult Congenital Heart Disease Center; Los Angeles California
- Division of Cardiology, Department of Pediatrics, David Geffen School of Medicine at UCLA; Los Angeles California
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Amat-Santos IJ, Ribeiro HB, Urena M, Allende R, Houde C, Bédard E, Perron J, DeLarochellière R, Paradis JM, Dumont E, Doyle D, Mohammadi S, Côté M, San Roman J, Rodés-Cabau J. Prosthetic Valve Endocarditis After Transcatheter Valve Replacement. JACC Cardiovasc Interv 2015; 8:334-346. [DOI: 10.1016/j.jcin.2014.09.013] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/05/2014] [Accepted: 09/10/2014] [Indexed: 11/29/2022]
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100
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Nasr VG, Kussman BD. Advances in the Care of Adults With Congenital Heart Disease. Semin Cardiothorac Vasc Anesth 2014; 19:175-86. [DOI: 10.1177/1089253214563989] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The significant decline in mortality among children and adolescents with congenital heart disease (CHD) is associated with an increasing prevalence of CHD in adults, particularly those with moderate to severe defects. As a significant percentage of adolescents and young adults are lost to follow-up in the transition from pediatric to adult care, they may present for elective procedures with substantial CHD-associated morbidity. In addition to the specific cardiac defect, the procedures performed, and the current pathophysiological status, several factors should be considered when managing the adult with CHD. These include the type of setting (adult vs pediatric institution); surgeon (pediatric vs adult cardiac surgeon); coexisting diseases associated with CHD, such as coronary artery disease, hepatic dysfunction, renal dysfunction, cerebrovascular accidents, myopathy, and coagulation disorders; acquired diseases of aging; pregnancy; and psychosocial functioning. The current status of the management of common and important congenital cardiac defects is also described.
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