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Matoq A, Shahanavaz S. Transcatheter Pulmonary Valve in Congenital Heart Disease. Interv Cardiol Clin 2024; 13:369-384. [PMID: 38839170 DOI: 10.1016/j.iccl.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Over the last 2 decades, experience with transcatheter pulmonary valve replacement (TPVR) has grown significantly and has become an effective and reliable way of treating pulmonary valve regurgitation, right ventricular outflow (RVOT) obstruction, and dysfunctional bioprosthetic valves and conduits. With the introduction of self-expanding valves and prestents, dilated native RVOT can be addressed with the transcatheter approach. In this article, the authors review the current practices, technical challenges, and outcomes of TPVR.
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Affiliation(s)
- Amr Matoq
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Shabana Shahanavaz
- Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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2
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Al Nasef M, Erdem A, Aldudak B, Yildirim A, Hijazi ZM, Boudjemline Y, Al Riyami Z, Zunzunegui JL, Al Sahari A, Al Deham M, Meer Y, Al Alwi K, Al Saloos H, Abdulhamed J, AlShahrani D, Al Qahtani F, Al Tamimi O, Alissa M, Al Otay AM, Momenah T. Multicenter Experience for Early and Mid-Term Outcome of MyVal Transcatheter Pulmonary Valve Implantation. Pediatr Cardiol 2024; 45:570-579. [PMID: 38296854 DOI: 10.1007/s00246-023-03398-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024]
Abstract
Transcatheter pulmonary valve implantation (TPVI) is a surgical alternative for correcting dysfunctional right ventricular outflow tract in previously operated patients. MyVal transcatheter heart valve (THV) (Meril Life Sciences, India), a new transcatheter valve designed for aortic position has recently been reported to be implanted in pulmonary position. Myval transcatheter valve were implanted in patients with stenosed dysfunctional conduits, severe regurgitation from transannular patch or dysfunctional surgical pulmonary valves (Bioprosthesis). Procedural details and post-TPVI follow-up were analysed. Myval TPVI was used in Fifty three patients with median age of 15 years (IQR 12-19.5 years). Almost sixty percent of the patients were male, with a median weight of 50 kg (31-63 kg). Prestenting was used in more than 80 percent of patients (n = 45 patients), while 6 patients had a prior surgical valve implantation. After Myval TPVI implantation, the peak instantaneous gradient across the RVOT decreased from a median of 23.5 mmHg (IQR 10-53 mmHg) pre-procedure to 10 mmHg (IQR 5-16 mmHg) post-procedure. The median fluoroscopy time for the procedure was 35 min (IQR 23.5-44 min). The large sizes-mainly the 29-mm and 32 mm Myval (Navigator, Meril Life Sciences Pvt Ltd, India), were the most used size in 40% (n = 22) of the cases each. The median contrast volume used during the procedure was 247 mL (IQR 120-300 mL). Patients were followed for a median period of 360 days (IQR 164-525 days). At the last clinic follow-up, there was no tricuspid valve regurgitation. Moderate neo-pulmonary valve regurgitation was reported in three cases. Early experience of TPVI with MyVal is encouraging with procedural success in all patients and acceptable mid-term outcomes.
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Affiliation(s)
- Mohamed Al Nasef
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
- King Hamd American Mission Hospital, Manama, Kingdom of Bahrain
| | | | - Bedri Aldudak
- Diyarbakır Gazi Yaşargil Training and Research Hospital, Istanbul, Turkey
| | - Ayse Yildirim
- Kosuyolu High Education Training and Research Hospital, Istanbul, Turkey
| | | | | | | | | | | | - Meshal Al Deham
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
- King Saud Medical City, Riyadh, Saudi Arabia
| | - Yaser Meer
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
- Dr Mohammad Al Fagih Hospital, Jeddah, Saudi Arabia
| | - Khalid Al Alwi
- Sultan Qaboos University, Muscat, Sultanate of Oman
- National Heart Center, Muscat, Sultanate of Oman
| | | | | | | | - Faleh Al Qahtani
- King Abdul Aziz Cardiac Center, Riyadh, Saudi Arabia
- College of Applied Sciences, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | | | | | - Tarek Momenah
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia.
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Kagiyama Y, Kenny D, Hijazi ZM. Current status of transcatheter intervention for complex right ventricular outflow tract abnormalities. Glob Cardiol Sci Pract 2024; 2024:e202407. [PMID: 38404661 PMCID: PMC10886730 DOI: 10.21542/gcsp.2024.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/11/2023] [Indexed: 02/27/2024] Open
Abstract
Various transcatheter interventions for the right ventricular outflow tract (RVOT) have been introduced and developed in recent decades. Transcatheter pulmonary valve perforation was first introduced in the 1990s. Radiofrequency wire perforation has been the approach of choice for membranous pulmonary atresia in newborns, with high success rates, although complication rates remain relatively common. Stenting of the RVOT is a novel palliative treatment that may improve hemodynamics in neonatal patients with reduced pulmonary blood flow and RVOT obstruction. Whether this option is superior to other surgical palliative strategies or early primary repair of tetralogy of Fallot remains unclear. Transcatheter pulmonary valve replacement has been one of the biggest innovations in the last two decades. With the success of the Melody and SAPIEN valves, this technique has evolved into the gold standard therapy for RVOT abnormalities with excellent procedural safety and efficacy. Challenges remain in managing the wide heterogeneity of postoperative lesions seen in RVOT, and various technical modifications, such as pre-stenting, valve ring modification, or development of self-expanding systems, have been made. Recent large studies have revealed outcomes comparable to those of surgery, with less morbidity. Further experience and multicenter studies and registries to compare the outcomes of various strategies are necessary, with the ultimate goal of a single-step, minimally invasive approach offering the best longer-term anatomical and physiological results.
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Affiliation(s)
- Yoshiyuki Kagiyama
- Department of Pediatric Cardiology, Children’s Health Ireland at Crumlin, Dublin 12, Republic of Ireland
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
| | - Damien Kenny
- Department of Pediatric Cardiology, Children’s Health Ireland at Crumlin, Dublin 12, Republic of Ireland
| | - Ziyad M. Hijazi
- Department of Cardiovascular Diseases, Sidra Medicine, and Weill Cornell Medical College, Doha, Qatar
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Álvarez-Fuente M, Toledano M, Garrido-Lestache E, Sánchez I, Molina I, Rivero N, García-Ormazábal I, Del Cerro MJ. Balloon-Expandable Pulmonary Valves for Patched or Native Right Ventricular Outflow Tracts. Pediatr Cardiol 2023:10.1007/s00246-023-03173-2. [PMID: 37147525 DOI: 10.1007/s00246-023-03173-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/19/2023] [Indexed: 05/07/2023]
Abstract
The implantation of percutaneous balloon expandable valves in native or patched right ventricular outflow tracts (nRVOT) is a challenging technique due to the diversity of anatomies and shapes, the large sizes, and the distensibility of the nRVOT, for which specific techniques have been developed. We present a single center experience with balloon expandable percutaneous pulmonary valves in nRVOT, describing the techniques used, complications observed, and a short-mid term follow-up.. This is a single center descriptive study of patients who underwent a percutaneous pulmonary valve implantation in a nRVOT with a balloon expandable pulmonary valve in our center between September 2012 and June 2022.. We implanted successfully 45 valves in 46 patients (20 Sapien and 25 Melody). Tetralogy of Fallot or pulmonary atresia with VSD were the main congenital heart disease (n = 32). All were pre-stented, 18 in a one step procedure. We used a Dryseal sheath in 13/21 Sapien. In 6 patients we used the anchoring technique, 5 with a very large nRVOT and one pyramidal nRVOT. In the 3.5 year follow-up 7 patients developed endocarditis and 3 required a valve redilation, no fractures were observed. PPVI of native RVOT with balloon expandable valves is feasible in a number of selected anatomies, including large or pyramidal nRVOT, using specific techniques, (presenting, LPA anchoring).
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Affiliation(s)
- M Álvarez-Fuente
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain.
| | - M Toledano
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - E Garrido-Lestache
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - I Sánchez
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - I Molina
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - N Rivero
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - I García-Ormazábal
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
| | - M J Del Cerro
- Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain
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Patel ND, Levi DS, Cheatham JP, Qureshi SA, Shahanavaz S, Zahn EM. Transcatheter Pulmonary Valve Replacement: A Review of Current Valve Technologies. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2022; 1:100452. [PMID: 39132347 PMCID: PMC11307711 DOI: 10.1016/j.jscai.2022.100452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/06/2022] [Accepted: 08/17/2022] [Indexed: 08/13/2024]
Abstract
Transcatheter pulmonary valve replacement was first performed by Dr Philip Bonhoeffer, who implanted a Medtronic Melody valve in a human in 2000. Over the past 2 decades, there have been many advances in transcatheter pulmonary valve technology. This includes the use of the SAPIEN transcatheter heart valve in the pulmonary position, modifications and refinements to valve implantation procedures, and development of self-expanding valves and prestents to treat large diameter native or patched right ventricular outflow tracts. This article reviews the current transcatheter pulmonary valve technologies with a focus on valve design, screening process, implant procedure, and clinical outcomes.
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Affiliation(s)
- Neil D. Patel
- Children’s Hospital Los Angeles, Los Angeles, California
| | - Daniel S. Levi
- Mattel Children's Hospital at The University of California, Los Angeles, Los Angeles, California
| | | | | | | | - Evan M. Zahn
- Cedars-Sinai Medical Center, Los Angeles, California
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Kenny D, Hijazi ZM. Transcatheter Pulmonary Valve Replacement. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Abudayyeh I, Jolly GP, Kuhn MA, Gordon BM. Transcatheter Systemic AV Valve-in-Valve Implantation in a Patient With LTGA and Ebstein Anomaly. JACC Case Rep 2022; 4:551-555. [PMID: 35573851 PMCID: PMC9091525 DOI: 10.1016/j.jaccas.2022.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 02/01/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
We present the first in-human transcatheter systemic atrioventricular valve-in-valve implantation in a 37-year-old patient with Ebstein anomaly, levo-transposition of the great arteries, and prior systemic valve replacement. She had severe bioprosthetic valve regurgitation and reduced systolic function. She had high surgical risk and was planned for transcatheter intervention. (Level of Difficulty: Advanced.)
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Affiliation(s)
- Islam Abudayyeh
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
- Address for correspondence: Dr Islam Abudayyeh, Division of Cardiology, Loma Linda University Medical Center, 2068 Orange Tree Lane, Suite 215, Redlands, California 92374, USA. @AbudayyehIslam
| | - George P. Jolly
- Division of Cardiology, Loma Linda University Medical Center, Loma Linda, California, USA
| | - Michael A. Kuhn
- Division of Pediatric Cardiology, Loma Linda University Children’s Hospital and Medical Center, Loma Linda, California, USA
| | - Brent M. Gordon
- Division of Pediatric Cardiology, Loma Linda University Children’s Hospital and Medical Center, Loma Linda, California, USA
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Spigel ZA, Adachi I, Binsalamah ZM, Parekh D, Qureshi AM. Transcatheter pulmonic valve implantation in adult patients with prior congenital heart surgery. Ann Cardiothorac Surg 2021; 10:658-666. [PMID: 34733693 DOI: 10.21037/acs-2021-tviv-28] [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: 08/16/2021] [Accepted: 09/09/2021] [Indexed: 11/06/2022]
Abstract
Background Transcatheter pulmonary valve replacement (TPVR) is now an established modality for pulmonary valve replacement in suitable candidates. We aim to describe our experience with TPVR in adults. Methods This is a descriptive study of all TPVR performed in adults with congenital heart disease at a single institution from 2010-2020. All adult patients (defined as 18 years old or older at TPVR) were included. Time-to-event outcomes were described using Kaplan-Meier estimates with 95% confidence intervals (CIs). Results Out of a total of 200 patients that had undergone TPVR, 81 patients (57% male) met the inclusion criteria, with a median age and weight of 26 years (IQR 21-37) and 71.0 kg (IQR 54.6-89.0), respectively. In the cohort, 45 (56%) patients had tetralogy of Fallot. While 53 (65%) patients received a Melody valve, a Sapien valve (S3 in 20, XT in eight) was implanted in the rest. Pre-stenting was performed in 49 (52%) patients. One patient died of severe heart failure a year following TPVR. One patient had a second TPVR performed 2.2 years following initial TPVR for severe pulmonary regurgitation. Valve survival at 2.2 years was 94% (95% CI: 87-100%). Four patients developed endocarditis. Endocarditis-free survival was 89% (95% CI: 80-100%) at three years. Conclusions Our experience suggests favorable results of TPVR in adults with congenital heart disease. Additional research would be warranted with a focus on total valve longevity and patient reported outcomes, in order to improve the understanding of TPVR in this population and further refine this technology.
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Affiliation(s)
- Zachary A Spigel
- Department of Surgery, Allegheny Health Network, Pittsburgh, PA, USA
| | - Iki Adachi
- Department of Surgery, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Ziyad M Binsalamah
- Department of Surgery, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Dhaval Parekh
- The Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Athar M Qureshi
- The Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
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10
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Law MA, Chatterjee A. Transcatheter pulmonic valve implantation: Techniques, current roles, and future implications. World J Cardiol 2021; 13:117-129. [PMID: 34131475 PMCID: PMC8173335 DOI: 10.4330/wjc.v13.i5.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/11/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023] Open
Abstract
Right ventricular outflow tract (RVOT) obstruction is present in a variety of congenital heart disease states including tetralogy of Fallot, pulmonary atresia/stenosis and other conotruncal abnormalities etc. After surgical repair, these patients develop RVOT residual abnormalities of pulmonic stenosis and/or insufficiency of their native outflow tract or right ventricle to pulmonary artery conduit. There are also sequelae of other surgeries like the Ross operation for aortic valve disease that lead to right ventricle to pulmonary artery conduit dysfunction. Surgical pulmonic valve replacement (SPVR) has been the mainstay for these patients and is considered standard of care. Transcatheter pulmonic valve implantation (TPVI) was first reported in 2000 and has made strides as a comparable alternative to SPVR, being approved in the United States in 2010. We provide a comprehensive review in this space–indications for TPVI, detailed procedural facets and up-to-date review of the literature regarding outcomes of TPVI. TPVI has been shown to have favorable medium-term outcomes free of re-interventions especially after the adoption of the practice of pre-stenting the RVOT. Procedural mortality and complications are uncommon. With more experience, recognition of risk of dreaded outcomes like coronary compression has improved. Also, conduit rupture is increasingly being managed with transcatheter tools. Questions over endocarditis risk still prevail in the TPVI population. Head-to-head comparisons to SPVR are still limited but available data suggests equivalence. We also discuss newer valve technologies that have limited data currently and may have more applicability for treatment of native dysfunctional RVOT substrates.
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Affiliation(s)
- Mark Aaron Law
- Department of Pediatric Cardiology, Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL 35233, United States
| | - Arka Chatterjee
- Division of Cardiology, University of Arizona College of Medicine, Tuscon, AZ 85724, United States
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Novel Minimal Radiation Approach for Percutaneous Pulmonary Valve Implantation. Pediatr Cardiol 2021; 42:926-933. [PMID: 33590323 DOI: 10.1007/s00246-021-02564-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
The aim of the study is to evaluate the impact of multimodality imaging technology during percutaneous pulmonary valve implantation (PPVI). Among percutaneous procedures, PPVI traditionally has one of the highest patient radiation exposures. Different protocol modifications have been implemented to address this problem (i.e., improvements in guidance systems, delivery systems, valve design, post-implantation evaluation). Although the effectiveness of individual modifications has been proven, the effect of an approach which combines these changes has not been reported. We performed a retrospective chart review of 76 patients who underwent PPVI between January 2018 and December 2019. Patients were classified in "Traditional protocol," using routine biplane angiography and/or 3D rotational angiography (3DRA); and "Multimodality protocol" that included the use of VesselNavigator for guidance, selective 3DRA for coronary evaluation, Long DrySeal Sheath for valve delivery, and Intracardiac Echocardiography for valve evaluation after implantation. Radiation metrics, procedural time, and clinical outcomes were compared between groups. When the traditional protocol group was compared with the multimodality protocol group, a significant reduction was described for total fluoroscopy time (31.6 min vs. 26.2 min), dose of contrast per kilogram (1.8 mL/Kg vs. 0.9 mL/Kg), DAP/kg (26.6 µGy·m2/kg vs. 19.9 µGy·m2/kg), and Air Kerma (194 mGy vs. 99.9 mGy). A reduction for procedure time was noted (140 min vs. 116.5 min), but this was not statistically significant. There was no difference in clinical outcomes or the presence of complications between groups. The combination of novel technology in PPVI caused a significant reduction in radiation metrics without increasing the complication rate in our population.
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Shahanavaz S, Zahn EM, Levi DS, Aboulhousn JA, Hascoet S, Qureshi AM, Porras D, Morgan GJ, Bauser Heaton H, Martin MH, Keeshan B, Asnes JD, Kenny D, Ringewald JM, Zablah JE, Ivy M, Morray BH, Torres AJ, Berman DP, Gillespie MJ, Chaszczewski K, Zampi JD, Walsh KP, Julien P, Goldstein BH, Sathanandam SK, Karsenty C, Balzer DT, McElhinney DB. Transcatheter Pulmonary Valve Replacement With the Sapien Prosthesis. J Am Coll Cardiol 2021; 76:2847-2858. [PMID: 33303074 DOI: 10.1016/j.jacc.2020.10.041] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND There are limited published data focused on outcomes of transcatheter pulmonary valve replacement (TPVR) with either a Sapien XT or Sapien 3 (S3) valve. OBJECTIVES This study sought to report short-term outcomes in a large cohort of patients who underwent TPVR with either a Sapien XT or S3 valve. METHODS Data were entered retrospectively into a multicenter registry for patients who underwent attempted TPVR with a Sapien XT or S3 valve. Patient-related, procedural, and short-term outcomes data were characterized overall and according to type of right ventricular outflow tract (RVOT) anatomy. RESULTS Twenty-three centers enrolled a total of 774 patients: 397 (51%) with a native/patched RVOT; 183 (24%) with a conduit; and 194 (25%) with a bioprosthetic valve. The S3 was used in 78% of patients, and the XT was used in 22%, with most patients receiving a 29-mm (39%) or 26-mm (34%) valve. The implant was technically successful in 754 (97.4%) patients. Serious adverse events were reported in 67 patients (10%), with no difference between RVOT anatomy groups. Fourteen patients underwent urgent surgery. Nine patients had a second valve implanted. Among patients with available data, tricuspid valve injury was documented in 11 (1.7%), and 9 others (1.3%) had new moderate or severe regurgitation 2 grades higher than pre-implantation, for 20 (3.0%) total patients with tricuspid valve complications. Valve function at discharge was excellent in most patients, but 58 (8.5%) had moderate or greater pulmonary regurgitation or maximum Doppler gradients >40 mm Hg. During limited follow-up (n = 349; median: 12 months), 9 patients were diagnosed with endocarditis, and 17 additional patients underwent surgical valve replacement or valve-in-valve TPVR. CONCLUSIONS Acute outcomes after TPVR with balloon-expandable valves were generally excellent in all types of RVOT. Additional data and longer follow-up will be necessary to gain insight into these issues.
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Affiliation(s)
- Shabana Shahanavaz
- Division of Cardiology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Evan M Zahn
- Guerin Family Congenital Heart Program, The Heart Institute and Department of Pediatrics Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Daniel S Levi
- Department of Pediatrics, Division of Cardiology, UCLA Mattel Children's Hospital, Los Angeles, California, USA
| | - Jamil A Aboulhousn
- Department of Medicine, Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | | | - Athar M Qureshi
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Diego Porras
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Gareth J Morgan
- The Heart Institute, Children's Hospital of Colorado, Anschutz Medical Campus, Denver, Colorado, USA
| | - Holly Bauser Heaton
- Division of Cardiology Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mary Hunt Martin
- Division of Pediatric Cardiology, University of Utah, Primary Children's Hospital, Salt Lake City, Utah, USA
| | | | | | - Damien Kenny
- Our Lady's Children's Hospital and Mater Hospital, Dublin, Ireland
| | | | - Jenny E Zablah
- The Heart Institute, Children's Hospital of Colorado, Anschutz Medical Campus, Denver, Colorado, USA
| | - Margaret Ivy
- The Heart Institute, Children's Hospital of Colorado, Anschutz Medical Campus, Denver, Colorado, USA
| | - Brian H Morray
- Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA
| | - Alejandro J Torres
- Division of Pediatric Cardiology, NewYork-Presbyterian/Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York, New York, USA
| | - Darren P Berman
- The Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Matthew J Gillespie
- University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kasey Chaszczewski
- University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jeffrey D Zampi
- Department of Pediatrics and Communicable Diseases, University of Michigan C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA
| | - Kevin P Walsh
- Our Lady's Children's Hospital and Mater Hospital, Dublin, Ireland
| | - Plessis Julien
- Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France
| | - Bryan H Goldstein
- The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | | | | | - David T Balzer
- Division of Cardiology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Doff B McElhinney
- Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA
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Horlick EM, Haas NA. Percutaneous Pulmonary Valve Replacement: What a Difference a Day Makes. J Am Coll Cardiol 2021; 76:2859-2861. [PMID: 33303075 DOI: 10.1016/j.jacc.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/02/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Eric M Horlick
- Division of Cardiology, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto Ontario.
| | - Nikolaus A Haas
- Department of Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich, Munich, Germany
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Stapleton GE, Gowda ST, Bansal M, Khan A, Qureshi AM, Justino H. SAPIEN S3
valve deployment in the pulmonary position using the gore
DrySeal
sheath to protect the tricuspid valve. Catheter Cardiovasc Interv 2020; 96:1287-1293. [DOI: 10.1002/ccd.29120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/28/2020] [Accepted: 06/08/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Gary E. Stapleton
- Department of Pediatrics, Charles E. Mullins Cardiac Catheterization Laboratories Texas Children's Hospital, and Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine Houston Texas USA
| | - Srinath T Gowda
- Department of Pediatrics, Charles E. Mullins Cardiac Catheterization Laboratories Texas Children's Hospital, and Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine Houston Texas USA
| | - Manish Bansal
- Department of Pediatrics, Charles E. Mullins Cardiac Catheterization Laboratories Texas Children's Hospital, and Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine Houston Texas USA
| | - Asra Khan
- Department of Pediatrics, Charles E. Mullins Cardiac Catheterization Laboratories Texas Children's Hospital, and Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine Houston Texas USA
| | - Athar M Qureshi
- Department of Pediatrics, Charles E. Mullins Cardiac Catheterization Laboratories Texas Children's Hospital, and Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine Houston Texas USA
| | - Henri Justino
- Department of Pediatrics, Charles E. Mullins Cardiac Catheterization Laboratories Texas Children's Hospital, and Lillie Frank Abercrombie Section of Cardiology, Baylor College of Medicine Houston Texas USA
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15
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Maschietto N, Sperotto F, Esch JE, Porras D, Callahan R. The snared wire technique for Sapien valve implantation in the pulmonary position. Catheter Cardiovasc Interv 2020; 96:898-903. [PMID: 32438505 DOI: 10.1002/ccd.28970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/24/2020] [Accepted: 05/04/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Description of the snared wire technique (SWT) to facilitate the delivery of the Sapien valve in pulmonary position, and comparison with standard delivery technique. BACKGROUND Transcatheter pulmonary valve replacement (TPVR) with the Sapien delivery system has proven to be challenging. Therefore, alternative strategies for facilitating its delivery in this position are needed. METHODS Retrospective analysis of patients who underwent TPVR with or without the new SWT. The SWT was chosen as an elective strategy when the anatomy was judged to be challenging for TPVR (planned SWT) or as a rescue strategy when a standard delivery failed (rescue SWT). RESULTS From February 2018 to January 2020, 84 patients underwent TPVR with a Sapien S3 valve using either a standard delivery (n = 63, 75%) or a SWT (n = 21, 25%). Fifteen patients underwent a planned SWT, six patients underwent a rescue SWT after failure of a standard delivery. All planned SWT cases were successful and, compared to the standard delivery group, no significant differences were found in terms of time to valve-deployment, fluoroscopy time, procedure time, or frequency of complications. Rescue SWT cases had longer fluoroscopy time (p = .05), longer time to valve-deployment (p = .0001), and higher frequency of complications (p = .002) including tricuspid valve injury (p = .0004), but allowed the operator to successfully implant the valve into the desired location. CONCLUSIONS Even in the most challenging anatomies, the SWT represents a feasible and effective alternative strategy for TPVR with the Sapien valve that should be considered when other techniques have failed.
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Affiliation(s)
- Nicola Maschietto
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Francesca Sperotto
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Jesse E Esch
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Diego Porras
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ryan Callahan
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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16
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Misumida N, Anderson JH, Greason KL, Rihal CS. Antegrade transseptal transcatheter aortic valve replacement: Back to the future? Catheter Cardiovasc Interv 2020; 96:E552-E556. [DOI: 10.1002/ccd.28934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/02/2020] [Accepted: 04/13/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Naoki Misumida
- Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA
| | - Jason H. Anderson
- Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA
| | - Kevin L. Greason
- Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA
| | - Charanjit S. Rihal
- Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA
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17
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Fukuda T, Tan W, Sadeghi S, Lin J, Salem M, Levi D, Aboulhosn J. Utility of the long DrySeal sheath in facilitating transcatheter pulmonary valve implantation with the Edwards Sapien 3 valve. Catheter Cardiovasc Interv 2020; 96:E646-E652. [DOI: 10.1002/ccd.28776] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/27/2020] [Accepted: 02/07/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Terunobu Fukuda
- Department of Medicine Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA Los Angeles California
| | - Weiyi Tan
- Department of Medicine Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA Los Angeles California
| | - Soraya Sadeghi
- Department of Medicine Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA Los Angeles California
| | - Jeannette Lin
- Department of Medicine Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA Los Angeles California
| | - Morris Salem
- Department of Pediatrics Division of Cardiology, Kaiser Permanente Los Angeles California
| | - Daniel Levi
- Department of Medicine Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA Los Angeles California
- Department of Pediatrics, Division of Cardiology, UCLA Mattel Children's Hospital Los Angeles California
| | - Jamil Aboulhosn
- Department of Medicine Ahmanson Adult Congenital Heart Disease Center, David Geffen School of Medicine at UCLA Los Angeles California
- Department of Pediatrics, Division of Cardiology, UCLA Mattel Children's Hospital Los Angeles California
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18
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Aggarwal V, Spigel ZA, Hiremath G, Binsalamah Z, Qureshi AM. Current clinical management of dysfunctional bioprosthetic pulmonary valves. Expert Rev Cardiovasc Ther 2020; 18:7-16. [DOI: 10.1080/14779072.2020.1715796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Varun Aggarwal
- Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN, USA
| | - Zachary A Spigel
- Department of Pediatric Surgery, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Gurumurthy Hiremath
- Division of Pediatric Cardiology, Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN, USA
| | - Ziyad Binsalamah
- Department of Pediatric Surgery, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Athar M Qureshi
- The Lillie Frank Abercrombie Section of Cardiology, Department of Pediatric Cardiology, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
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