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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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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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Houeijeh A, Sudre A, Juthier F, Godart F. Pulmonary valve replacement in a large and tortuous right ventricle outflow tract with a 32 mm Myval valve under local anaesthesia: challenges and technical considerations: a case report. Eur Heart J Case Rep 2023; 7:ytad322. [PMID: 37547365 PMCID: PMC10404027 DOI: 10.1093/ehjcr/ytad322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/01/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023]
Abstract
Background Pulmonary valve replacement in patients with congenital heart diseases and heart failure is challenging. Case summary Here, we describe a case of a patient who had surgical fallot repair with chronic heart failure. Investigations found severe biventricular dysfunction and enlargement due to chronic pulmonary regurgitation. The right ventricle outflow tract was tortuous and large with a diameter of 35 mm. Percutaneous pulmonary valve implantation (PPVI) was done after a challenging pre-stenting. A 32 mm Myval valve over-sized to 35 mm was used for PPVI, which yielded a good result. Discussion A 32 mm Myval valve is effective at extending the possibilities of PPVI in a large and tortuous right ventricle outflow tract not accessible for the other valves.
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Affiliation(s)
| | - Arnaud Sudre
- Cardiac Functional Explorations and Catheterization Unit, ICP, Lille University Hospital, rue Pr. Leclerc, Lille University, UFR3S, 59000 Lille, France
| | - Francis Juthier
- Cardiac Surgery Unit, Lille University Hospital, ICP, rue de Pr.Leclerc Lille University, UFR3S, 59000 Lille, France
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Shao Z, Song S, Han Y, Liang W, Fan T. First hybrid implantations of novel Salus-Valves in patients with severe pulmonary regurgitation: A case series. Front Cardiovasc Med 2022; 9:1059664. [PMID: 36505356 PMCID: PMC9729770 DOI: 10.3389/fcvm.2022.1059664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
With the increasing age of patients after right ventricular outflow tract (RVOT) reconstruction, progressive pulmonary valve (PV) dysfunction can result in different degrees of right heart insufficiency, and PV replacement is frequently needed during follow-up. The traditional redo thoracotomy is difficult and associated with higher risks when compared to transcatheter implantations. Herein, we report the advantages and describe the outcomes of the first hybrid implantations of the novel Salus-Valves (Balance Medical, Beijing, China) from the sub-xiphoid approach in five patients (mean age of 22.6 years) with severe pulmonary regurgitation (PR) after RVOT reconstruction.
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Affiliation(s)
- Zehua Shao
- Children’s Heart Center, Zhengzhou University People’s Hospital, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Shubo Song
- Children’s Heart Center, Zhengzhou University People’s Hospital, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Yu Han
- Department of Structural Cardiology, Zhengzhou University People’s Hospital, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Zhengzhou, China,*Correspondence: Yu Han,
| | - Weijie Liang
- Children’s Heart Center, Zhengzhou University People’s Hospital, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Taibing Fan
- Children’s Heart Center, Zhengzhou University People’s Hospital, Fuwai Central China Cardiovascular Hospital, Henan Provincial People’s Hospital, Zhengzhou, China,Taibing Fan,
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