1
|
Terrade G, Borenstein N, Chetboul V, Toma C, Guillaume E, Bruneval P, Fiette L, Carazo Arias LE, Morlet A, Le Dudal M. First reported long-term two- and three-dimensional echocardiographic follow-up with histopathological analysis of a transcatheter pulmonary valve implantation in a pet dog. J Vet Cardiol 2024; 53:52-59. [PMID: 38688090 DOI: 10.1016/j.jvc.2024.04.001] [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] [Received: 12/19/2023] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
Transcatheter pulmonary valve implantation (TPVI) is indicated for use in the management of failing pulmonary valves in humans. We report here the long-term follow-up of the first documented transcatheter pulmonary valve implanted in a client-owned dog. A one-year-old Beagle dog with severe congenital type A valvular pulmonic stenosis first underwent percutaneous balloon pulmonary valvuloplasty, leading two years later to severe pulmonary regurgitation. A TPVI using a Melody™ bioprosthetic valve was then successfully performed, with normalization of the right heart cavities. Repeated two- and three-dimensional transthoracic echocardiographic examinations combined with Doppler modes confirmed the appropriate position and function of the valve for four years. Mitral myxomatous valvular degeneration led to refractory left-sided congestive heart failure, and the dog was humanely euthanized. After postmortem examination, X-ray imaging and histopathological evaluation of the stent and the valve were performed. Ex-vivo imaging of the implanted valve using a Faxitron® Path radiography system and microscopic evaluation of the implanted stent and bioprosthetic leaflets did not show any relevant leaflet or stent alterations. This case provides a proof of concept in interventional veterinary cardiology, showing that TPVI can be performed in dogs with subsequent long-term maintaining normal pulmonary valve function.
Collapse
Affiliation(s)
- G Terrade
- Veranex Preclinical Services, 42 Bd Jourdan, 75014 Paris, France; Ecole Nationale Vétérinaire d'Alfort, Unité d'Histologie et d'Anatomie-Pathologique, Biopôle Alfort, 7 Av. du Général de Gaulle, 94700 Maisons-Alfort, France
| | - N Borenstein
- Veranex Preclinical Services, 42 Bd Jourdan, 75014 Paris, France.
| | - V Chetboul
- Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie d'Alfort (UCA), Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), 7 Av. du Général de Gaulle, 94700 Maisons-Alfort, France; U955, Equipe 03, INSERM (Institut National de la santé et de la recherche médicale), 8 rue du Général Sarrail, 94010 Créteil, France
| | - C Toma
- Veranex Preclinical Services, 42 Bd Jourdan, 75014 Paris, France
| | - E Guillaume
- Veranex Preclinical Services, 42 Bd Jourdan, 75014 Paris, France
| | - P Bruneval
- Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Department of Pathology, 20 Rue Leblanc, 75015 Paris, France
| | - L Fiette
- Veranex Preclinical Services, 42 Bd Jourdan, 75014 Paris, France
| | - L E Carazo Arias
- Veranex Preclinical Services, 42 Bd Jourdan, 75014 Paris, France
| | - A Morlet
- Veranex Preclinical Services, 42 Bd Jourdan, 75014 Paris, France
| | - M Le Dudal
- Ecole Nationale Vétérinaire d'Alfort, Unité d'Histologie et d'Anatomie-Pathologique, Biopôle Alfort, 7 Av. du Général de Gaulle, 94700 Maisons-Alfort, France
| |
Collapse
|
2
|
Pan W, Zhou D, Hijazi ZM, Qureshi SA, Promphan W, Feng Y, Zhang G, Liu X, Pan X, Chen L, Cao Q, Tiong KG, Leong MC, Roymanee S, Prachasilchai P, Choi JY, Tomita H, Le Tan J, Akhtar K, Lam S, So K, Tin DN, Nguyen LH, Huo Y, Wang J, Ge J. 2024 Statement from Asia expert operators on transcatheter pulmonary valve replacement. Catheter Cardiovasc Interv 2024; 103:660-669. [PMID: 38419402 DOI: 10.1002/ccd.30978] [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: 09/14/2023] [Revised: 11/13/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Abstract
Transcatheter pulmonary valve replacement (TPVR), also known as percutaneous pulmonary valve implantation, refers to a minimally invasive technique that replaces the pulmonary valve by delivering an artificial pulmonary prosthesis through a catheter into the diseased pulmonary valve under the guidance of X-ray and/or echocardiogram while the heart is still beating not arrested. In recent years, TPVR has achieved remarkable progress in device development, evidence-based medicine proof and clinical experience. To update the knowledge of TPVR in a timely fashion, and according to the latest research and further facilitate the standardized and healthy development of TPVR in Asia, we have updated this consensus statement. After systematical review of the relevant literature with an in-depth analysis of eight main issues, we finally established eight core viewpoints, including indication recommendation, device selection, perioperative evaluation, procedure precautions, and prevention and treatment of complications.
Collapse
Affiliation(s)
- Wenzhi Pan
- Zhongshan Hopital, Fudan University, Shanghai, China
| | - Daxin Zhou
- Zhongshan Hopital, Fudan University, Shanghai, China
| | - Ziyad M Hijazi
- Pediatrics & Medicine, Weill Cornell Medicine, Doha, Qatar
| | | | - Worakan Promphan
- Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Yuan Feng
- West China Hospital, Sichuan University, Chengdu, China
| | | | - Xianbao Liu
- Second Hospital of Zhejiang Medical University, Hangzhou, China
| | - Xin Pan
- Shanghai Chest Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | | | | | | | | | | | - Pimpak Prachasilchai
- Queen Sirikit National Institute of Child Health, Pediatric Cardiac Center, Thailand
| | | | | | - Ju Le Tan
- National Heart Center, Singapore, Singapore
| | - Khurram Akhtar
- Armed Forces Institute of Cardiology National Institute of Heart Diseases, Rawalpindi, Pakistan
| | - Simon Lam
- Queen Marry Hospital, Hong Kong, China
| | - Kent So
- The Chinese University of Hong Kong, Hong Kong, China
| | - Do N Tin
- Children's Hospital, Hanoi, Vietnam
| | | | - Yong Huo
- Peking University First Hospital, Beijing, China
| | - Jian'an Wang
- Second Hospital of Zhejiang Medical University, Hangzhou, China
| | - Junbo Ge
- Zhongshan Hopital, Fudan University, Shanghai, China
| |
Collapse
|
3
|
Borenstein N, Chetboul V, Passavin P, Morlet A, Fernandez-Parra R, Carazo Arias LE, Giannettoni G, Saponaro V, Poissonnier C, Ghazal S, Lefort S, Trehiou-Sechi E, Marchal CR, Delle Cave J, Vannucci E, Behr L, Verwaerde P. Successful transcatheter pulmonary valve implantation in a dog: first clinical report. J Vet Cardiol 2019; 26:10-18. [PMID: 31785529 DOI: 10.1016/j.jvc.2019.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 09/10/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
Transcatheter pulmonary valve (TPV) implantation is a therapeutic approach approved by the United States Food and Drug Administration for human patients with failing pulmonary conduits in 2010 and for failing bioprosthetic surgical pulmonary valves in 2017. We report here the first successful transcatheter implantation of a stented valve in a pulmonary position in a dog with congenital pulmonary valve disease. A 3-year-old, 10.9 kg, client-owned Beagle dog was referred for a follow-up visit after a percutaneous balloon valvuloplasty performed 22 months before for treatment of a severe type A valvular pulmonary stenosis. The Doppler-derived peak pressure gradient was 348 mmHg before the procedure and 66 mmHg 24 h after. The dog was lethargic. Echocardiography revealed a mild pulmonary stenosis (pressure gradient-43 mmHg), severe pulmonary regurgitation, and secondary severe right ventricular and right atrial dilation. Worsening of right heart dilation was observed 2 months later despite medical therapy. A TPV implantation was performed using a prestented Melody bovine jugular bioprosthetic valve. The dog recovered uneventfully and was discharged 10 days after the procedure. Right heart dilation resolved within 15 days. The dog was doing well 7 months after valve implantation. This case demonstrates that TPV implantation with a stented valve is technically feasible in dogs with severe pulmonary valve disease. Stringent postoperative care, with particular attention to thrombosis and infectious endocarditis, and appropriate sizing and positioning of the valve stent are keys to the success of this procedure.
Collapse
Affiliation(s)
- N Borenstein
- IMMR 42 Boulevard Jourdan, 74014, Paris, France.
| | - V Chetboul
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie D'Alfort, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France; INSERM, (Institut national de la santé et de la recherche médicale), U955, Equipe 03, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - P Passavin
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie D'Alfort, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - A Morlet
- IMMR 42 Boulevard Jourdan, 74014, Paris, France
| | - R Fernandez-Parra
- INSERM, (Institut national de la santé et de la recherche médicale), U955, Equipe 03, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France; Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Pôle Anesthésie-Réanimation-Urgence-Soins Intensifs, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | | | - G Giannettoni
- Centre Hospitalier Vétérinaire ADVETIA, 9 Avenue Louis Breguet, 78140, Vélizy-Villacoublay, France
| | - V Saponaro
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie D'Alfort, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - C Poissonnier
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie D'Alfort, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - S Ghazal
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie D'Alfort, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - S Lefort
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie D'Alfort, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - E Trehiou-Sechi
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Cardiologie D'Alfort, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - C R Marchal
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Pôle Anesthésie-Réanimation-Urgence-Soins Intensifs, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - J Delle Cave
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Pôle Anesthésie-Réanimation-Urgence-Soins Intensifs, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - E Vannucci
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Pôle Anesthésie-Réanimation-Urgence-Soins Intensifs, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| | - L Behr
- IMMR 42 Boulevard Jourdan, 74014, Paris, France
| | - P Verwaerde
- INSERM, (Institut national de la santé et de la recherche médicale), U955, Equipe 03, 51 avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France; Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Pôle Anesthésie-Réanimation-Urgence-Soins Intensifs, Centre Hospitalier Universitaire Vétérinaire D'Alfort (CHUVA), 7 avenue du Général de Gaulle, 94704, Maisons-Alfort Cedex, France
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|