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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 182] [Impact Index Per Article: 182.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Hascoet S, Karsenty C, Fraisse A. Transcatheter Pulmonary Valve Replacement: History Is on the Move. JACC Cardiovasc Interv 2024; 17:245-247. [PMID: 38267138 DOI: 10.1016/j.jcin.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/05/2023] [Indexed: 01/26/2024]
Affiliation(s)
- Sébastien Hascoet
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de Médecine, Paris-Saclay, Université Paris-Saclay, Le Plessis Robinson, France; Royal Brompton Hospital and the National & Heart Institute, Imperial College, London, United Kingdom; Inserm UMR-S 999, Marie Lannelongue Hospital, Paris-Saclay University, Le Plessis Robinson, France.
| | - Clément Karsenty
- Department of Paediatric Cardiology, CHU Toulouse, Toulouse, France
| | - Alain Fraisse
- Royal Brompton Hospital and the National & Heart Institute, Imperial College, London, United Kingdom
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Hascoët S, Bentham JR, Giugno L, Betrián-Blasco P, Kempny A, Houeijeh A, Baho H, Sharma SR, Jones MI, Biernacka EK, Combes N, Georgiev S, Bouvaist H, Martins JD, Kantzis M, Turner M, Schubert S, Jalal Z, Butera G, Malekzadeh-Milani S, Valdeolmillos E, Karsenty C, Ödemiş E, Aldebert P, Haas NA, Khatib I, Wåhlander H, Gaio G, Mendoza A, Arif S, Castaldi B, Dohlen G, Carere RG, Del Cerro-Marin MJ, Kitzmüller E, Hermuzi A, Carminati M, Guérin P, Tengler A, Fraisse A. Outcomes of transcatheter pulmonary SAPIEN 3 valve implantation: an international registry. Eur Heart J 2024; 45:198-210. [PMID: 37874971 DOI: 10.1093/eurheartj/ehad663] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 09/11/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND AND AIMS Transcatheter pulmonary valve implantation (TPVI) is indicated to treat right-ventricular outflow tract (RVOT) dysfunction related to congenital heart disease (CHD). Outcomes of TPVI with the SAPIEN 3 valve that are insufficiently documented were investigated in the EUROPULMS3 registry of SAPIEN 3-TPVI. METHODS Patient-related, procedural, and follow-up outcome data were retrospectively assessed in this observational cohort from 35 centres in 15 countries. RESULTS Data for 840 consecutive patients treated in 2014-2021 at a median age of 29.2 (19.0-41.6) years were obtained. The most common diagnosis was conotruncal defect (70.5%), with a native or patched RVOT in 50.7% of all patients. Valve sizes were 20, 23, 26, and 29 mm in 0.4%, 25.5%, 32.1%, and 42.0% of patients, respectively. Valve implantation was successful in 98.5% [95% confidence interval (CI), 97.4%-99.2%] of patients. Median follow-up was 20.3 (7.1-38.4) months. Eight patients experienced infective endocarditis; 11 required pulmonary valve replacement, with a lower incidence for larger valves (P = .009), and four experienced pulmonary valve thrombosis, including one who died and three who recovered with anticoagulation. Cumulative incidences (95%CI) 1, 3, and 6 years after TPVI were as follows: infective endocarditis, 0.5% (0.0%-1.0%), 0.9% (0.2%-1.6%), and 3.8% (0.0%-8.4%); pulmonary valve replacement, 0.4% (0.0%-0.8%), 1.3% (0.2%-2.4%), and 8.0% (1.2%-14.8%); and pulmonary valve thrombosis, 0.4% (0.0%-0.9%), 0.7% (0.0%-1.3%), and 0.7% (0.0%-1.3%), respectively. CONCLUSIONS Outcomes of SAPIEN 3 TPVI were favourable in patients with CHD, half of whom had native or patched RVOTs.
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Affiliation(s)
- Sebastien Hascoët
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine Paris-Saclay, Université Paris-Saclay, BME laboratory, 133 avenue de la résistance, 92350 Le Plessis Robinson, France
- Royal Brompton Hospital, Sydney Street, London, Greater London SW3 6NP, UK
- Inserm UMR-S 999, Marie Lannelongue hospital, Paris-Saclay university, 133 avenue de la résistance, 92350 Le Plessis Robinson, France
| | - James R Bentham
- Leeds Teaching Hospitals NHS Trust, Yorkshire Heart Centre, Leeds, UK
| | - Luca Giugno
- Department of Paediatric Cardiology and Adults with congenital heart diseases, IRCCS-Policlinico San Donato, Via Morandi, 30, 20097 San Donato, Milan, Italy
| | - Pedro Betrián-Blasco
- Hospital Universitario Vall d'Hebron, Department of Paediatric Cardiology and Adults with Congenital Heart Diseases, Passeig de la Vall d'Hebron, 119, 08035 Barcelona, Spain
| | - Aleksander Kempny
- Royal Brompton Hospital, Sydney Street, London, Greater London SW3 6NP, UK
| | - Ali Houeijeh
- Centre Hospitalier Universitaire de Lille, Department of Paediatric Cardiology and Adults with Congenital Heart Diseases, 2 Av. Oscar Lambret, 59000 Lille, France
| | - Haysam Baho
- King Faisal Specialist Hospital, Department of Paediatric Cardiology and Adults with congenital heart diseases, Jeddah, Saudi Arabia
| | - Shiv-Raj Sharma
- Royal Brompton Hospital, Sydney Street, London, Greater London SW3 6NP, UK
| | - Matthew I Jones
- Evelina London Children's Hospital & St Thomas' Hospital, Departement of Paediatric Cardiology and Adults with Congenital Heart Diseases, Westminster Bridge Rd, London SE1 7EH, United Kingdom
| | - Elżbieta Katarzyna Biernacka
- Cardinal Stefan Wyszyński Institute of Cardiology, Department of Congenital Heart Diseases, Alpejska 42, 04-628 Warsaw, Poland
| | - Nicolas Combes
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine Paris-Saclay, Université Paris-Saclay, BME laboratory, 133 avenue de la résistance, 92350 Le Plessis Robinson, France
- Clinique Pasteur, Department of Cardiology, 31000 Toulouse, France
| | - Stanimir Georgiev
- Department of Congenital Heart Disease and Pediatric Cardiogy, German Heart Centre Munich, Technical University of Munich, Munich, Germany
| | - Hélène Bouvaist
- Service de Cardiologie, CHU Grenoble Alpes, Grenoble, France
| | - Jose Diogo Martins
- Paediatric Cardiology Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central-EPE, Lisbon, Portugal
| | - Marinos Kantzis
- Glenfield Hosp, Department of Paediatric Cardiology and Adults with Congenital Heart Diseases, Leicester, United Kingdom
| | - Mark Turner
- Bristol Heart Institute, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Stephan Schubert
- Centre for Congenital Heart Defects, Heart and Diabetes Centre Universitario North Rhine Westphalia, Department for Congenital Heart Defects, Ruhr University Bochum, 32545 Bad Oeynhausen, Germany
| | - Zakaria Jalal
- Pediatric and congenital heart diseases department, Bordeaux University Hospital, Pessac, France
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, CRCTB INSERM U1045, Bordeaux, France
| | - Gianfranco Butera
- Cardiology, Cardiac Surgery and Heart Lung transplantation, ERN GUARD HEART: Bambino Gesù Hospital and Research Institute, IRCCS, Rome, Italy
| | - Sophie Malekzadeh-Milani
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Estibaliz Valdeolmillos
- Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Faculté de médecine Paris-Saclay, Université Paris-Saclay, BME laboratory, 133 avenue de la résistance, 92350 Le Plessis Robinson, France
- Inserm UMR-S 999, Marie Lannelongue hospital, Paris-Saclay university, 133 avenue de la résistance, 92350 Le Plessis Robinson, France
| | - Clement Karsenty
- CHU Hôpital des enfants, Department of Paediatric Cardiology, Toulouse, France
| | - Ender Ödemiş
- Koç University Hospital, Department of Paediatric Cardiology and Adults with Congenital Heart Diseases, Davutpaşa Cd, 34010 Istanbul, Turkey
| | - Philippe Aldebert
- CHU Timone, Assistance Publique des Hôpitaux de Marseille, 278 rue Saint-Pierre, 13385 Marseille, France
| | - Nikolaus A Haas
- Department of Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilian University of Munich, Campus Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany
| | - Ihab Khatib
- Department of Paediatric Cardiology and Congenital Heart Disease in Adults, Rambam Healthcare Campus, Haifa, Israel
- Department of Paediatric Cardiology and Congenital Heart Disease in Adults, Sheba Medical Center, Tel HaShomer Hospital, Ramat Gan, Israël
| | - Håkan Wåhlander
- Paediatric Heart Centre, Queen Silvia Children's Hospital, Sahlgrenska University Hospital and Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gianpiero Gaio
- Paediatric Cardiology, Ospedali dei Colli, Luigi Vanvitelli University of Campania, Str. Vicinale Reggente, 66/82, 80131 Naples, Italy
| | - Alberto Mendoza
- Instituto Pediátrico del Corazón, Hospital Universitario 12 de Octubre, Av de Cordoba s/n, 28041 Madrid, Spain
| | - Sayqa Arif
- University Hospital Birmingham NHS Trust, Department of Paediatric Cardiology and Adults with Congenital Heart Diseases, Mindelsohn Way, Birmingham B15 2GW, United Kingdom
| | - Biagio Castaldi
- Paediatric Cardiology Unit, Department of Child and Woman's Health, University of Padua, Via VIII Febbraio, 2, 35122 Padua, Italy
| | - Gaute Dohlen
- University hospital, Department of Paediatric Cardiology and Adults with Congenital Heart Diseases, Oslo, Norway
| | - Ronald G Carere
- St Paul's Hospital, Department of Paediatric Cardiology and Adults with Congenital Heart Diseases, 1081 Burrard St, Vancouver, British Columbia V6Z 1Y6, Canada
| | - Maria Jesus Del Cerro-Marin
- Department of Paediatric Cardiology and Adults Congenital Heart Disease, H. Ramón y Cajal University Hospital, Madrid, Spain
| | - Erwin Kitzmüller
- Vienna General Hospital (AKH), Vienna Medical University, Vienna, Austria
| | - Antony Hermuzi
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital Newcastle upon Tyne, Newcastle, United Kingdom
| | - Mario Carminati
- Department of Paediatric Cardiology and Adults with congenital heart diseases, IRCCS-Policlinico San Donato, Via Morandi, 30, 20097 San Donato, Milan, Italy
| | - Patrice Guérin
- Centre Hospitalier Universitaire de Nantes, Department of Cardiology, 1 Pl. Alexis-Ricordeau, 44093 Nantes, France
| | - Anja Tengler
- Department of Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilian University of Munich, Campus Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany
| | - Alain Fraisse
- Royal Brompton Hospital, Sydney Street, London, Greater London SW3 6NP, UK
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Agwu N, Recto MR, Kheradvar A. Unmet Clinical Needs for Transcatheter Pulmonary Valves. Ann Biomed Eng 2023; 51:2384-2392. [PMID: 37543538 PMCID: PMC10637258 DOI: 10.1007/s10439-023-03328-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/18/2023] [Indexed: 08/07/2023]
Abstract
A common feature of congenital heart disease is the presence of right ventricular outflow tract (RVOT) obstruction that can range from mild to severe and can lead to atresia of the pulmonary valve, in extreme conditions. RVOT abnormalities can frequently be corrected surgically or via interventional means. However, most of these patients will ultimately develop pulmonary valve insufficiency and eventual right ventricular dilation, which will require a pulmonary valve replacement at some point in their life to mitigate the detrimental effects of pulmonary valve regurgitation (PVR) on the right ventricle (RV). The evolution from the studies done by Philip Bonhoeffer to implant a pulmonary valve via transcatheter means, have provided a bedrock for transcatheter pulmonary valve replacement (TPVR). Yet, several areas of unmet need for a demographic of patients still exist. Here, we discuss the clinical unmet needs in children under 20 Kg and expand the use of hybrid and other TPVR approaches along with the current indications and contraindications for pulmonary valve replacement. The constraints and limitations from commercially available pulmonary valves will be discussed from a clinical standpoint. Finally, we explore the use of hybrid and periventricular delivery of transcatheter pulmonary valves in younger patients.
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Affiliation(s)
- Nnaoma Agwu
- Department of Biomedical Engineering, University of California, 2420 Engineering Hall, Irvine, CA, 92697-2730, USA
| | | | - Arash Kheradvar
- Department of Biomedical Engineering, University of California, 2420 Engineering Hall, Irvine, CA, 92697-2730, USA.
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Machanahalli Balakrishna A, Dilsaver DB, Aboeata A, Gowda RM, Goldsweig AM, Vallabhajosyula S, Anderson JH, Simard T, Jhand A. Infective Endocarditis Risk with Melody versus Sapien Valves Following Transcatheter Pulmonary Valve Implantation: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. J Clin Med 2023; 12:4886. [PMID: 37568289 PMCID: PMC10419461 DOI: 10.3390/jcm12154886] [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: 04/20/2023] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Transcatheter pulmonary valve implantation (TPVI) is an effective non-surgical treatment method for patients with right ventricle outflow tract dysfunction. The Medtronic Melody and the Edwards Sapien are the two valves approved for use in TPVI. Since TPVI patients are typically younger, even a modest annual incidence of infective endocarditis (IE) is significant. Several previous studies have shown a growing risk of IE after TPVI. There is uncertainty regarding the overall incidence of IE and differences in the risk of IE between the valves. METHODS A systematic search was conducted in the MEDLINE, EMBASE, PubMed, and Cochrane databases from inception to 1 January 2023 using the search terms 'pulmonary valve implantation', 'TPVI', or 'PPVI'. The primary outcome was the pooled incidence of IE following TPVI in Melody and Sapien valves and the difference in incidence between Sapien and Melody valves. Fixed effect and random effect models were used depending on the valve. Meta-regression with random effects was conducted to test the difference in the incidence of IE between the two valves. RESULTS A total of 22 studies (including 10 Melody valve studies, 8 Sapien valve studies, and 4 studies that included both valves (572 patients that used the Sapien valve and 1395 patients that used the Melody valve)) were used for the final analysis. Zero IE incidence following TPVI was reported by eight studies (66.7%) that utilized Sapien valves compared to two studies (14.3%) that utilized Melody valves. The pooled incidence of IE following TPVI with Sapien valves was 2.1% (95% CI: 0.9% to 5.13%) compared to 8.5% (95% CI: 4.8% to 15.2%) following TPVI with Melody valves. Results of meta-regression indicated that the Sapien valve had a 79.6% (95% CI: 24.2% to 94.4%, p = 0.019; R2 = 34.4) lower risk of IE incidence compared to the Melody valve. CONCLUSIONS The risk of IE following TPVI differs significantly. A prudent valve choice in favor of Sapien valves to lower the risk of post-TPVI endocarditis may be beneficial.
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Affiliation(s)
| | - Danielle B. Dilsaver
- Department of Medicine, Division of Clinical Research and Public Health, Creighton University School of Medicine, Omaha, NE 68124, USA
| | - Ahmed Aboeata
- Division of Cardiovascular Medicine, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA
| | - Ramesh M. Gowda
- Department of Interventional Cardiology, Icahn School of Medicine at Mount Sinai Morningside and Beth Israel, New York, NY 10029, USA
| | - Andrew M. Goldsweig
- Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA 01199, USA
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - Saraschandra Vallabhajosyula
- Section of Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA
| | - Jason H. Anderson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Trevor Simard
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Aravdeep Jhand
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
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Lourtet-Hascoët J, Valdeolmillos E, Houeijeh A, Bonnet E, Karsenty C, Sharma SR, Kempny A, Iung B, Gatzoulis MA, Fraisse A, Hascoët S. Infective endocarditis after transcatheter pulmonary valve implantation in patients with congenital heart disease: Distinctive features. Arch Cardiovasc Dis 2023; 116:159-166. [PMID: 36842868 DOI: 10.1016/j.acvd.2023.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/18/2023]
Abstract
The introduction of transcatheter pulmonary valve implantation (TPVI) has greatly benefited the management of right ventricular outflow tract dysfunction. Infective endocarditis (IE) is a feared complication of TPVI that affects valve durability and patient outcomes. Current recommendations provide only limited guidance on the management of IE after TPVI (TPVI-IE). This article, by a group of experts in congenital heart disease in children and adults, interventional cardiology, infectious diseases including IE, and microbiology, provides a comprehensive review of the current evidence on TPVI-IE, including its incidence, risk factors, causative organisms, diagnosis, and treatment. The incidence of TPVI-IE varies from 13-91/1000 person-years for Melody valves to 8-17/1000 person-years for SAPIEN valves. Risk factors include history of IE, DiGeorge syndrome, immunosuppression, male sex, high residual transpulmonary gradient and portal of bacteria entry. Staphylococci and streptococci are the most common culprits, whereas Staphylococcus aureus is associated with the most severe disease. In addition to the modified Duke criteria, a high residual gradient warrants a strong suspicion. Imaging studies are helpful for the diagnosis. Intravenous antibiotics guided by blood culture results are the mainstay of treatment. Invasive re-intervention may be required. TPVI-IE in patients with congenital heart disease exhibits several distinctive features. Whether specific valve types are associated with a higher risk of TPVI-IE requires further investigation. Patient and parent education regarding IE prevention may have a role to play and should be offered to all patients.
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Affiliation(s)
- Julie Lourtet-Hascoët
- Department of Pediatric Cardiology and Adults with Congenital Heart Disease Centre, Royal Brompton Hospital, SW3 6NP London, UK; Clinical Microbiology Laboratory, Hôpital Saint Joseph, Groupe Hospitalier Paris Saint Joseph, 75014 Paris, France
| | - Estibaliz Valdeolmillos
- Pôle des cardiopathies congénitales, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Centre de Référence Cardiopathies Congénitales Complexes-réseau M3C, Faculté de Médecine, Université Paris-Saclay, INSERM UMR-S999, BME Lab, 92350 Le Plessis-Robinson, France
| | - Ali Houeijeh
- Department of Congenital Heart Disease, Lille University Hospital, 59000 Lille, France
| | - Eric Bonnet
- Infectious Diseases Mobile Unit, Clinique Pasteur, 31000 Toulouse, France
| | - Clément Karsenty
- Cardiologie pédiatrie, Hôpital des enfants, Centre de Compétence Cardiopathies Congénitales Complexes-réseau M3C- CHU Toulouse, 31000 Toulouse, France
| | - Shiv-Raj Sharma
- Department of Pediatric Cardiology and Adults with Congenital Heart Disease Centre, Royal Brompton Hospital, SW3 6NP London, UK
| | - Aleksander Kempny
- Department of Pediatric Cardiology and Adults with Congenital Heart Disease Centre, Royal Brompton Hospital, SW3 6NP London, UK
| | - Bernard Iung
- Service de Cardiologie, Hôpital Bichat, AP-HP, Université Paris-Cité, 75018 Paris, France
| | - Michael A Gatzoulis
- Department of Pediatric Cardiology and Adults with Congenital Heart Disease Centre, Royal Brompton Hospital, SW3 6NP London, UK; National Heart and Lung Institute, Imperial College, SW3 6LY London, UK
| | - Alain Fraisse
- Department of Pediatric Cardiology and Adults with Congenital Heart Disease Centre, Royal Brompton Hospital, SW3 6NP London, UK
| | - Sébastien Hascoët
- Department of Pediatric Cardiology and Adults with Congenital Heart Disease Centre, Royal Brompton Hospital, SW3 6NP London, UK; Pôle des cardiopathies congénitales, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Centre de Référence Cardiopathies Congénitales Complexes-réseau M3C, Faculté de Médecine, Université Paris-Saclay, INSERM UMR-S999, BME Lab, 92350 Le Plessis-Robinson, France.
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1446] [Impact Index Per Article: 1446.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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8
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Staged Percutaneous Management of Pulmonary Atresia and Intact Interventricular Septum: Stretching the Limits. J Interv Cardiol 2023; 2023:9709227. [PMID: 36793670 PMCID: PMC9908361 DOI: 10.1155/2023/9709227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/24/2022] [Accepted: 12/12/2022] [Indexed: 02/04/2023] Open
Abstract
Aims Pulmonary atresia with intact ventricular septum (PA/IVS) can be treated by catheter-based interventions and complemented by various surgical procedures. We aim to determine a long-term treatment strategy to enable patients to be surgery free, depending solely on percutaneous interventions. Methods and Results We selected five patients from among a cohort of patients with PA/IVS treated at birth with radiofrequency perforation and dilatation of the pulmonary valve. Patients had reached a pulmonary valve annulus of 20 mm or larger on their biannual echocardiographic follow-up, with right ventricular dilatation. The findings, together with the right ventricular outflow tract and pulmonary arterial tree, were confirmed by multislice computerised tomography. Based on the angiographic size of the pulmonary valve annulus, all patients were successfully implanted with either Melody® or Edwards® pulmonary valves percutaneously, regardless of their small weights and ages. No complications were encountered. Conclusion We managed to stretch the age and weight limitations for performing percutaneous pulmonary valve implantation (PPVI): interventions were attempted whenever a pulmonary annulus size of >20 mm was reached, which was rationalised by the prevention of progressive right ventricular outflow tract dilatation and accommodating valves between 24 and 26 mm, which is enough to sustain a normal pulmonary flow in adulthood.
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Gartenberg AJ, Gillespie MJ, Glatz AC. Transcatheter Approaches to Pulmonary Valve Replacement in Congenital Heart Disease: Revolutionizing the Management of RVOT Dysfunction? Semin Thorac Cardiovasc Surg 2022; 35:333-338. [DOI: 10.1053/j.semtcvs.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/11/2022]
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2617] [Impact Index Per Article: 1308.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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11
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Stammnitz C, Huscher D, Bauer UMM, Urban A, Nordmeyer J, Schubert S, Photiadis J, Berger F, Klaassen S. Nationwide Registry-Based Analysis of Infective Endocarditis Risk After Pulmonary Valve Replacement. J Am Heart Assoc 2022; 11:e022231. [PMID: 35179045 PMCID: PMC9075093 DOI: 10.1161/jaha.121.022231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Infective endocarditis (IE) after pulmonary valve replacements in congenital heart disease is a significant concern. This study aimed to identify specific long-term risk factors for IE after percutaneous pulmonary valve implantation or surgical pulmonary valve replacement. Methods and Results All patients with congenital heart disease from the National Register for Congenital Heart Defects with at least 1 pulmonary valve replacement before January 2018 were included. A total of 1170 patients (56.3% men, median age at study inclusion 12 [interquartile range {Q1-Q3} 5-20 years]) received 1598 pulmonary valve replacements. IE occurred in 4.8% of patients during a follow-up of total 9397 patient-years (median 10 [Q1-Q3, 6-10] years per patient). After homograft implantation 7 of 558 (1.3%) patients developed IE, after heterograft implantation 31 of 723 (4.3%) patients, and after Melody valve implantation 18 of 241 (7.5%) patients. Edwards Sapien and mechanical valves were used less frequently and remained without IE. The incidence of IE in heterografts excluding Contegra valves was 7 of 278 (2.5%), whereas the incidence of IE in Contegra valves was 24 of 445 (5.4%). The risk of IE was not increased compared with homografts if Contegra valves were excluded from the heterografts (hazard ratio [HR], 2.60; P=0.075). The risk of IE was increased for bovine jugular vein valves, Contegra valves (HR, 6.72; P<0.001), and Melody valves (HR, 5.49; P<0.001), but did not differ between Melody valves and Contegra valves (HR, 1.01; P=0.978). Conclusions Bovine jugular vein valves have the highest risk of IE, irrespective of the mode of deployment, either surgical or percutaneous.
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Affiliation(s)
- Clara Stammnitz
- Department of Pediatric Cardiology Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,Competence Network for Congenital Heart Defects National Register for Congenital Heart Defects Berlin Germany
| | - Dörte Huscher
- Institute of Biometry and Clinical Epidemiology Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Ulrike M M Bauer
- Competence Network for Congenital Heart Defects National Register for Congenital Heart Defects Berlin Germany.,DZHK (German Centre for Cardiovascular Research) Berlin Germany
| | - Aleksandra Urban
- Competence Network for Congenital Heart Defects National Register for Congenital Heart Defects Berlin Germany
| | - Johannes Nordmeyer
- Department of Congenital Heart Disease - Pediatric Cardiology German Heart Center Berlin Berlin Germany
| | - Stephan Schubert
- Department of Congenital Heart Disease - Pediatric Cardiology German Heart Center Berlin Berlin Germany.,Center for Congenital Heart Disease/Pediatric Cardiology Heart- and Diabetes Center NRW University Clinic of Ruhr-University Bochum Bad Oeynhausen Germany
| | - Joachim Photiadis
- Department of Congenital Heart Surgery - Pediatric Heart Surgery German Heart Center Berlin Berlin Germany
| | - Felix Berger
- Department of Pediatric Cardiology Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,Department of Congenital Heart Disease - Pediatric Cardiology German Heart Center Berlin Berlin Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin Berlin Germany
| | - Sabine Klaassen
- Department of Pediatric Cardiology Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,DZHK (German Centre for Cardiovascular Research), partner site Berlin Berlin Germany.,Experimental and Clinical Research Center (ECRC), a cooperation between the Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association and the Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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12
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Tannous P, Nugent A. Transcatheter pulmonary valve replacement in native and nonconduit right ventricle outflow tracts. J Thorac Cardiovasc Surg 2021; 162:967-970. [DOI: 10.1016/j.jtcvs.2020.07.126] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 01/24/2023]
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13
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Le Ruz R, Plessis J, Houeijeh A, Baruteau AE, Le Gloan L, Warin Fresse K, Karsenty C, Petit J, Godart F, Hascoët S, Guérin P. Edwards SAPIEN XT transcatheter pulmonary valve implantation: 5-year follow-up in a French Registry. Catheter Cardiovasc Interv 2021; 98:990-999. [PMID: 34227735 DOI: 10.1002/ccd.29862] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 06/08/2021] [Accepted: 06/18/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study sought to investigate patient intermediate-term outcomes after transcatheter pulmonary valve replacement (TPVR) with Edwards SAPIEN valve. BACKGROUND The Edwards SAPIEN valve, initially designed for percutaneous aortic valve replacement, has been approved for TPVR in patients with dysfunctional right ventricular outflow tracts (RVOT), but only short-term follow-up has been reported. METHODS From 2011 to 2016, 62 patients undergoing successful TPVR using the SAPIEN XT valve were consecutively included into the study. Primary efficacy and safety endpoints were defined as freedom from valve-reintervention and freedom from infective endocarditis at last follow-up, respectively. RESULTS The primary efficacy outcome was met for 87.1% patients after a mean follow-up of 4.6 ± 1.8 years, corresponding to a freedom of reintervention at 5 years of 89% (95% CI 74.8-95.6%). Reinterventions were exclusively due to recurrent obstruction, no significant valvular regurgitation was observed. One case of infective endocarditis was reported, corresponding to a rate of 0.35% per patient-year (95% CI 0.01-2.00%). At 5 years, freedom from infective endocarditis was 98.4% (95% CI 89.1-99.8%). Six patients died or were transplanted due to advanced cardiac failure, without relationship with TPVR. In univariate analysis, reintervention was associated with young age, a smaller tube-graft, a higher pulmonary valve gradient after the procedure and a ratio of largest implanted stent diameter to invasive balloon conduit diameter over 1.35. CONCLUSIONS This study documents the mid-term safety and efficacy of the Edwards SAPIEN XT valve in patients with dysfunctional RVOT, and identifies a patient profile associated with an uncertain benefit-risk balance.
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Affiliation(s)
- Robin Le Ruz
- Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France
| | - Julien Plessis
- Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France
| | - Ali Houeijeh
- Centre Hospitalier Régional Universitaire de Lille, Service de Cardiologie Infantile et Congénitale, Nantes, France.,Hôpital Marie Lannelongue, Pole de Chirurgie des Cardiopathies Congénitales, Groupe hospitalier Paris Saint Joseph, M3C- Centre de Reference Malformations Cardiaques Congénitales Complexes, Université Paris-Saclayl, Paris, France
| | - Alban-Elouen Baruteau
- Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France.,L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France.,Department of Pediatric Cardiology and Pediatric Cardiac Surgery, M3C Regional Reference Center, CHU Nantes, Nantes, France.,Department of Congenital Cardiology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Laurianne Le Gloan
- Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France
| | - Karine Warin Fresse
- Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France
| | - Clément Karsenty
- Hôpital Marie Lannelongue, Pole de Chirurgie des Cardiopathies Congénitales, Groupe hospitalier Paris Saint Joseph, M3C- Centre de Reference Malformations Cardiaques Congénitales Complexes, Université Paris-Saclayl, Paris, France.,Paediatric and Congenital Cardiology, Children's Hospital, CHU Toulouse, Toulouse University, Toulouse, France
| | - Jérôme Petit
- Hôpital Marie Lannelongue, Pole de Chirurgie des Cardiopathies Congénitales, Groupe hospitalier Paris Saint Joseph, M3C- Centre de Reference Malformations Cardiaques Congénitales Complexes, Université Paris-Saclayl, Paris, France
| | - François Godart
- Centre Hospitalier Régional Universitaire de Lille, Service de Cardiologie Infantile et Congénitale, Nantes, France
| | - Sébastien Hascoët
- Hôpital Marie Lannelongue, Pole de Chirurgie des Cardiopathies Congénitales, Groupe hospitalier Paris Saint Joseph, M3C- Centre de Reference Malformations Cardiaques Congénitales Complexes, Université Paris-Saclayl, Paris, France.,INSERM UMR-S999, Hôpital Marie Lannelongue, Université Paris-Saclay, Paris, France
| | - Patrice Guérin
- Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France
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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: 52] [Impact Index Per Article: 17.3] [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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16
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Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3176] [Impact Index Per Article: 1058.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Transcatheter pulmonary valve implantation in 100 patients: a 10-year single-center experience. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2020; 16:235-243. [PMID: 33597988 PMCID: PMC7863798 DOI: 10.5114/aic.2020.99257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 08/30/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Transcatheter pulmonary valve implantation (TPVI) is a non-surgical method of treatment for patients with right ventricular outflow tract (RVOT) dysfunction after surgical repair of congenital heart defects (CHD). Aim To evaluate the long-term results of TPVI performed in a single center. Material and methods: Over 10 years, TPVI was performed in 100 patients (mean age: 26.4 ±8.1 years), using Melody Medtronic or Sapien Edwards valves. Results The initial success rate of TPVI was 93%. In 7 cases (5 urgent), a switch to surgical intervention was necessary due to periprocedural complications (all patients survived). Following TPVI, none of the 93 patients had severe pulmonary regurgitation. The pulmonary gradient decreased from 49.0 ±37.8 before to 27.6 ±14.9 mm Hg directly after TPVI (p < 0.0001). Right ventricular end-diastolic volume decreased, while NYHA class and pVO2 uptake significantly improved in 1 year after TPVI. Freedom from reintervention was 100% in 1 year. Freedom from serious adverse events was 86% in mean 5.5 years of observation. The main reason for reintervention was infective endocarditis (IE) (1.6% patients/year). Increased risk of IE was associated with severe PS before valve implantation and the suboptimal result of TPVI. The incidence of IE seems to be lower in patients treated permanently with antiplatelet therapy (1.8% vs. 0.9% patients/year, NS). Conclusions TPVI is a safe and effective method of treatment in patients with RVOT dysfunction after surgical correction of CHD. To achieve a good outcome, precise patient selection and rigorous IE prevention are necessary.
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Said SM. Commentary: Transcatheter valve therapy for the right ventricular outflow tract: Right as rain, ready for Roger. J Thorac Cardiovasc Surg 2020; 162:973-974. [PMID: 33618882 DOI: 10.1016/j.jtcvs.2020.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 09/13/2020] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Sameh M Said
- Division of Pediatric Cardiovascular Surgery, Masonic Children's Hospital, University of Minnesota, Minneapolis, Minn.
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19
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3-Dimensional personalized planning for transcatheter pulmonary valve implantation in a dysfunctional right ventricular outflow tract. Int J Cardiol 2020; 309:33-39. [DOI: 10.1016/j.ijcard.2019.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 11/23/2022]
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20
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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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21
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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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22
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Implantation of the Edwards SAPIEN XT and SAPIEN 3 valves for pulmonary position in enlarged native right ventricular outflow tract. Anatol J Cardiol 2020; 25:96-103. [PMID: 33583816 DOI: 10.14744/anatoljcardiol.2020.46024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Percutaneous pulmonary valve implantation (PPVI) into right ventricle-to-pulmonary artery conduits is increasingly being performed, but a few options are available for patients with a dilated native right ventricular outflow tract (RVOT), among which is the off-label use of Ed-wards SAPIEN® valves. This study reviews the results of the SAPIEN XT and SAPIEN 3 (S3) valve implantations in the pulmonary position in patients with a dilated native RVOT. METHODS Between January 2015 and March 2020, PPVI procedures were performed on 129 patients. Among them, 103 (80%) had dilated native RVOT, 86 of whom were eligible for PPVI prestenting and valve implantation. Retrospective analysis was performed on 84 patients who have undergone successful PPVI implantation using the SAPIEN XT or S3 valves with dilated native RVOT. RESULTS The procedural success rate was 84/86 (98%). The median age was 18.7 years (8-46 years), and the median weight was 57 kg (22-102 kg). The primary underlying diagnosis was tetralogy of Fallot (n=77/84). Stenting was performed simultaneously with valve implantation in 50/84 (60%) cases-six of which were hybrid procedures-whereas prestenting was performed 3 to 14 weeks earlier in 34/84 cases. Before valve im-plantation, the median right anterior oblique and lateral diameters of the stents were 26 mm (20-32 mm) and 28 mm (21-32 mm). Valve sizes were 26 mm (n=13) and 29 mm (n=64) for XT and 29 mm (n=7) for S3. In 59 patients, an additional 1-5 ml (median 2 ml) volume was added to the valves' balloons for stabilization. In all hybrid procedures, the stent and valve were implanted in the same session. During follow-ups of 1 to 59 months (median 14 months), no deaths were reported, 3 patients developed tricuspid regurgitation secondary to the procedure, and valves continued to function in all patients. CONCLUSION The Edwards SAPIEN XT and S3 valves may be an alternative to PPVI in patients with dilated native RVOT.
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23
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The risk of infective endocarditis following interventional pulmonary valve implantation: A meta-analysis. J Cardiol 2019; 74:197-205. [DOI: 10.1016/j.jjcc.2019.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/22/2019] [Accepted: 04/13/2019] [Indexed: 11/19/2022]
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24
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Lehner A, Dashkalova T, Ulrich S, Fernandez Rodriguez S, Mandilaras G, Jakob A, Dalla-Pozza R, Fischer M, Schneider H, Tarusinov G, Kampmann C, Hofbeck M, Dähnert I, Kanaan M, Haas NA. Intermediate outcomes of transcatheter pulmonary valve replacement with the Edwards Sapien 3 valve - German experience. Expert Rev Med Devices 2019; 16:829-834. [PMID: 31432698 DOI: 10.1080/17434440.2019.1653180] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: After encouraging results with the Edwards Sapien and XT valves, this study aimed to review procedural data and early outcomes for the Sapien 3 valves for transcatheter pulmonary valve replacement (TPVR). Methods: We performed a multicenter, retrospective analysis of cases who underwent a Sapien 3 TPVR between 2015 and 2017 in 7 centers in Germany with a follow-up of up to 2 years. Results: 56 patients could be enrolled (weight 58,5 ± 25,0 kg; 53% Tetralogy of Fallot, 45% native RVOT). Most procedures were two-stage procedures (82,1%) with 100% prestenting. Valve sizes were 20 mm (n = 1), 23 mm (n = 15), 26 mm (n = 27), 29 mm (n = 13). Procedural success rate was 96.4%. Two patients underwent surgical valve implantation after balloon rupture during TPVR. Follow-up data were available up to 24-month post TPVR. The rate of patients with ? moderate and severe pulmonary regurgitation decreased to 0% after TPVR, peak systolic gradient decreased from 24,2 (SD±20,9) mmHg to 7,1 mmHg (SD±5,0). There were no endocarditis, severe tricuspid valve impairment or stent fractures. Conclusions: With the Edwards Sapien 3 valve, the patient pool for TPVR can be substantially extended. Continued data collection is necessary to verify long-term results.
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Affiliation(s)
- Anja Lehner
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Tsvetina Dashkalova
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Sarah Ulrich
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Silvia Fernandez Rodriguez
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Guido Mandilaras
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Andre Jakob
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Robert Dalla-Pozza
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Marcus Fischer
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
| | - Heike Schneider
- Department for Pediatric Cardiology and Intensive Care, Heart Center Goettingen, Georg-August-University Goettingen , Goettingen , Germany
| | - Gleb Tarusinov
- Department for Pediatric Cardiology, Heart Center Duisburg , Duisburg , Germany
| | - Christoph Kampmann
- Department for Pediatric Cardiology, University Medical Center Mainz , Mainz , Germany
| | - Michael Hofbeck
- Department for Pediatric Cardiology, University Hospital Tuebingen , Tuebingen , Germany
| | - Ingo Dähnert
- Department for Pediatric Cardiology, Heart Center Leipzig , Leipzig , Germany
| | - Majed Kanaan
- Center for Congenital Heart Defects, Heart and Diabetes Centre North Rhine Westphalia, Ruhr University Bochum , Bad Oeynhausen , Germany
| | - Nikolaus A Haas
- Department for Pediatric Cardiology and Intensive Care, Medical Hospital of the University of Munich, LMU Ludwig Maximilians University Munich , Munich , Germany
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25
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Rajpopat AD, Schmidt MR, Søndergaard L. Time to reconsider when to re-valve for free pulmonary regurgitation in tetralogy of Fallot? EUROINTERVENTION 2019; 14:1344-1346. [DOI: 10.4244/eijv14i13a242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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