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Right ventricular outflow tract stenting

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https://www.readbyqxmd.com/read/29724567/infective-endocarditis-after-percutaneous-pulmonary-valve-implantation-a-long-term-single-centre-experience
#1
Daniel Tanase, Peter Ewert, Alfred Hager, Stanimir Georgiev, Julie Cleuziou, John Hess, Andreas Eicken
BACKGROUND: Patients with congenital cardiovascular disease involving the right ventricular outflow tract and with prosthetic valves in the heart are at high risk for developing infective endocarditis (IE). Recently, there has been concern about relatively high rates of IE after percutaneous pulmonary valve implantation (PPVI). Although there are factors specific to percutaneous valves that could plausibly contribute to the risk of IE, including procedural steps prior to implantation such as crimping the valved stent or mechanical forces during dilation, little is known about actual risk factors for this complication...
April 22, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29671282/interventional-cardiology-for-congenital-heart-disease
#2
REVIEW
Damien Kenny
Congenital heart interventions are now replacing surgical palliation and correction in an evolving number of congenital heart defects. Right ventricular outflow tract and ductus arteriosus stenting have demonstrated favorable outcomes compared to surgical systemic to pulmonary artery shunting, and it is likely surgical pulmonary valve replacement will become an uncommon procedure within the next decade, mirroring current practices in the treatment of atrial septal defects. Challenges remain, including the lack of device design focused on smaller infants and the inevitable consequences of somatic growth...
March 29, 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29521437/first-human-implant-of-the-alterra-adaptive-prestent-tm-a-new-self-expanding-device-designed-to-remodel-the-right-ventricular-outflow-tract
#3
Evan M Zahn, Jennifer C Chang, Dustin Armer, Ruchira Garg
Current balloon expandable transcatheter valves have limited applicability to patients with "native" right ventricular outflow tracts (RVOT), meaning those who have had previous surgery and are left with large, compliant, irregular RVOT. The Alterra Adaptive PrestentTM is a self-expanding, partially covered stent that was designed to internally reconfigure these types of RVOT, making them suitable for implantation of a commercially available balloon expandable heart valve, the SAPIEN 3. Herein, we describe the first human implant of this device...
May 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29395214/transcatheter-pulmonary-valve-replacement-using-the-melody-valve-for-treatment-of-dysfunctional-surgical-bioprostheses-a-multicenter-study
#4
Allison K Cabalka, Jeremy D Asnes, David T Balzer, John P Cheatham, Matthew J Gillespie, Thomas K Jones, Henri Justino, Dennis W Kim, Te-Hsin Lung, Daniel R Turner, Doff B McElhinney
BACKGROUND: Stented bioprosthetic valves (BPVs) are commonly used for surgical pulmonary valve (PV) replacement in postoperative congenital heart disease, but develop structural failure in a time-related fashion. The Melody transcatheter PV (TPV) (Medtronic, Minneapolis, Minn) has been used to treat BPV dysfunction, but there have been few studies in this population. METHODS: We performed a retrospective, multicenter study to evaluate Melody valve function in patients who underwent TPV replacement (TPVR) into a dysfunctional pulmonary BPV...
April 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29352588/pulmonary-reinterventions-after-complete-unifocalization-and-repair-in-infants-and-young-children-with-tetralogy-of-fallot-with-major-aortopulmonary-collaterals
#5
Holly Bauser-Heaton, Alejandro Borquez, Ritu Asija, Lisa Wise-Faberowski, Yulin Zhang, Laura Downey, Stanton B Perry, Andrew Koth, Lynn F Peng, Claudia A Algaze, Frank L Hanley, Doff B McElhinney
BACKGROUND: Our institutional approach to tetralogy of Fallot (TOF) with major aortopulmonary collaterals (MAPCAs) emphasizes unifocalization and augmentation of the reconstructed pulmonary arterial (PA) circulation and complete intracardiac repair in infancy, usually in a single procedure. This approach yields a high rate of complete repair with excellent survival and low right ventricular (RV) pressure. However, little is known about remodeling of the unifocalized and reconstructed pulmonary circulation or about reinterventions on the reconstructed PAs or the RV outflow tract conduit...
April 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29277931/percutaneous-pulmonary-valve-implantation-in-grown-up-congenital-heart-disease-patients-insights-from-the-zurich-experience
#6
Luca Oechslin, Roberto Corti, Matthias Greutmann, Oliver Kretschmar, Oliver Gaemperli
OBJECTIVES: The aim of the study was to assess indications, procedural success, complications, echocardiographic, and clinical outcomes of percutaneous pulmonary valve implantation (PPVI) in adult patients with congenital heart disease (CHD). BACKGROUND: PPVI offers a non-surgical treatment option for failing prosthetic conduits in pulmonary position. However, efficacy and clinical outcomes after PPVI are still underreported. METHODS: From January 2008 to March 2016, 25 adult CHD patients with right ventricular outflow tract (RVOT) stenosis and/or pulmonary regurgitation underwent PPVI in our institution...
December 25, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29181862/perforation-and-right-ventricular-outflow-tract-stenting-alternative-palliation-for-infants-with-pulmonary-atresia-ventricular-septal-defect
#7
David Aurigemma, John W Moore, Gabrielle Vaughn, Nasser Moiduddin, Howaida G El-Said
BACKGROUND: Right ventricular outflow tract (RVOT) stents have been used as palliation in patients with severe tetralogy of Fallot (TOF). Radiofrequency perforation of the RVOT has also been described in patients with pulmonary atresia (PA)/ventricular septal defect (VSD). However, RVOT stenting in conjunction with radiofrequency perforation as a means for establishing reliable pulmonary blood flow in patients with PA/VSD has not previously been reported. OBJECTIVES: Our aim is to report our experience with using perforation of plate-like pulmonary valve atresia combined with stenting of RVOT as an alternative and equally efficacious intervention for infants with PA/VSD, as compared to a surgical pulmonary artery shunt (SPS)...
November 27, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29127709/pulmonary-damage-following-right-ventricular-outflow-tachycardia-ablation-in-a-child-when-electroanatomical-mapping-isn-t-good-enough
#8
Neha Bansal, Daisuke Kobayashi, Peter P Karpawich
A 14-year-old female was referred for severe pulmonary valve insufficiency after undergoing radiofrequency ablation for a right ventricular outflow tract tachycardia that originated in the proximal pulmonary artery at 10 years of age. Clinical records indicated that ablation was guided solely by electrograms and electroanatomical mapping. Due to myocardial tissue extensions, mapping failed to identify the level of the pulmonary valve annulus, which resulted in delivery of energy on the valve proper and into the pulmonary artery...
November 11, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28944581/a-new-one-step-procedure-for-pulmonary-valve-implantation-of-the-melody-valve-simultaneous-prestenting-and-valve-implantation
#9
Younes Boudjemline
OBJECTIVES: To describe a new modification, the one-step procedure, that allows interventionists to pre-stent and implant a Melody valve simultaneously. BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is the standard of care for managing patients with dysfunctional right ventricular outflow tract, and the approach is standardized. METHODS: Patients undergoing PPVI using the one-step procedure were identified in our database. Procedural data and radiation exposure were compared to those in a matched group of patients who underwent PPVI using the conventional two-step procedure...
January 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28940794/percutaneous-pulmonary-valve-implantation-for-reconstruction-of-a-patch-repaired-right-ventricular-outflow-tract
#10
Anoosh Esmaeili, Simone Bollmann, Markus Khalil, Roberta De Rosa, Stephan Fichtlscherer, Hakan Akintuerk, Dietmar Schranz
Percutaneous pulmonary valve implantation (PPVI) is nowadays an accepted treatment option to repair post-surgical conduit dysfunction of the right ventricular outflow tract (RVOT). In addition, many patients need a pulmonary valve to reconstruct a hemodynamically incompetent native or conduit free outflow tract. Based on our experience with percutaneous stent-valve placement in a cohort of 125 patients, we report here transvenous reconstruction of a conduit-free, patch repaired outflow tract by utilizing balloon-expandable stent-valves in 23 patients with a median age of 22 years (5-60 years)...
February 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28928615/stenting-of-right-ventricular-outflow-tract-in-tetralogy-of-fallot-with-subarterial-ventricular-septal-defect-a-word-of-caution
#11
Jonathan Lee, Sivakumar Sivalingam, Mazeni Alwi
We report a case of Tetralogy of Fallot with severe cyanosis who underwent a successful right ventricular outflow tract stenting. Follow-up echocardiography revealed moderate aortic regurgitation due to the impingement of the stent on the aortic valve. The patient underwent successful surgical correction at which time the stent was removed completely with a resolution of the aortic regurgitation.
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28895301/early-leaflet-thrombosis-complicating-transcatheter-implantation-of-a-sapien-3-valve-in-a-native-right-ventricular-outflow-tract
#12
Mounir Riahi, Philipp Blanke, John Webb, Ronald G Carere
A 59-year-old female with Tetralogy of Fallot had a previous complete repair with RVOT patch enlargement. She developed subsequent severe symptomatic (NYHA III) pulmonary regurgitation with severe RV dilatation. She had a concomitant interstitial lung disease secondary to hypersensitivity pneumonitis that precluded her from cardiac surgery. After preprocedural assessment using computed tomography, echocardiography and invasive angiography we decided to implant a 29 mm Edwards Sapien 3 valve without pre-stenting...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895283/right-ventricle-outflow-tract-prestenting-in-vitro-testing-of-rigidity-and-corrosion-properties
#13
Bjorn Cools, Stephen Brown, Martine Wevers, Jan Van Humbeeck, Derize Boshoff, Cis Verdonckt, Marc Gewillig
BACKGROUND: The aim of this study was to assess the resistance to compression (stiffness) of frequently used stents for right ventricular outflow tract prestenting. In addition, to assess the corrosion potential when different types of stent alloys come into contact with each other. METHOD: Different stents were tested in vitro in various combinations at specialized metallurgic laboratories. A bench compression test was used to assess resistance to compression of singular and joined combinations of stents...
February 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28882285/stenting-of-the-right-ventricular-outflow-tract-promotes-better-pulmonary-arterial-growth-compared-with-modified-blalock-taussig-shunt-palliation-in-tetralogy-of-fallot-type-lesions
#14
Daniel Quandt, Bharat Ramchandani, John Stickley, Chetan Mehta, Vinay Bhole, David J Barron, Oliver Stumper
OBJECTIVES: This study sought to compare pulmonary arterial (PA) growth during palliation after right ventricular outflow tract (RVOT) stenting versus modified Blalock-Taussig shunt (mBTS) in patients coming forward for complete repair of tetralogy of Fallot-type lesions. BACKGROUND: RVOT stenting is a recent alternative to mBTS in the initial palliation of selected patients with Fallot-type lesions. METHODS: This was a retrospective, single-center study of nonrandomized, consecutive palliated Fallot patients over a 10-year period...
September 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28857726/initial-assessment-of-a-novel-delivery-system-nudel%C3%A2-%C3%A2-for-the-covered-cheatham-platinum-stent
#15
Gareth J Morgan, Damien Kenny, Christopher Duke, Kevin P Walsh, Shakeel A Qureshi
Aims We sought to evaluate the first-in-man use of a new system for implantation of covered stents in patients with complex structural and CHD. Methods and results Retrospective data were collected of the first 13 NuDEL™ delivery systems used in patients. The NuDEL™ comprises a covered Cheatham-Platinum stent mounted on a balloon-in-balloon and pre-loaded in a long delivery sheath. Data were collected from three centres in the United Kingdom and Ireland. A total of 13 covered stents were delivered via 12 NuDEL™ delivery systems in 12 patients...
October 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28851718/acute-and-midterm-outcomes-of-transcatheter-pulmonary-valve-replacement-for-treatment-of-dysfunctional-left-ventricular-outflow-tract-conduits-in-patients-with-aortopulmonary-transposition-and-a-systemic-right-ventricle
#16
Wendy Whiteside, Justin T Tretter, Jamil Aboulhosn, Osamah Aldoss, Aimee K Armstrong, Martin L Bocks, Matthew J Gillespie, Thomas K Jones, Mary Hunt Martin, Jeffrey J Meadows, Christina M Metcalf, Mariel E Turner, Thomas Zellers, Bryan H Goldstein
BACKGROUND: Transcatheter pulmonary valve replacement (TPVR) is an established therapy for dysfunctional right ventricular (RV) outflow tract conduits. TPVR in patients with congenitally corrected transposition of the great arteries, subpulmonary left ventricle, and left ventricular outflow tract (LVOT) conduit dysfunction has not been studied. Unique anatomic and physiological aspects of this population may contribute to distinct risks and outcomes. METHODS AND RESULTS: Across 10 US centers, 27 patients with a dysfunctional LVOT conduit were evaluated in the catheterization laboratory between December 2008 and August 2015 with the intent to perform TPVR...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28814489/right-ventricular-outflow-tract-stent-versus-bt-shunt-palliation-in-tetralogy-of-fallot
#17
COMPARATIVE STUDY
Daniel Quandt, Bharat Ramchandani, Gemma Penford, John Stickley, Vinay Bhole, Chetan Mehta, Timothy Jones, David James Barron, Oliver Stumper
OBJECTIVE: This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions. METHODS: Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period...
December 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28712577/bacterial-adherence-to-graft-tissues-in-static-and-flow-conditions
#18
Tiago Rafael Veloso, Jorien Claes, Soetkin Van Kerckhoven, Bartosz Ditkowski, Luis G Hurtado-Aguilar, Stefan Jockenhoevel, Petra Mela, Ramadan Jashari, Marc Gewillig, Marc F Hoylaerts, Bart Meyns, Ruth Heying
BACKGROUND: Various conduits and stent-mounted valves are used as pulmonary valve graft tissues for right ventricular outflow tract reconstruction with good hemodynamic results. Valve replacement carries an increased risk of infective endocarditis (IE). Recent observations have increased awareness of the risk of IE after transcatheter implantation of a stent-mounted bovine jugular vein valve. This study focused on the susceptibility of graft tissue surfaces to bacterial adherence as a potential risk factor for subsequent IE...
January 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#19
Auras R Atreya, Mitkumar Patel, Senthil K Sivalingam, Mathias L Stoenescu
A 67-year-old man with coronary artery disease (CAD) and left anterior descending artery (LAD) stent presented with symptomatic monomorphic ventricular tachycardia (VT) at a rate of 190 bpm requiring cardioversion. ECG showed left bundle branch block pattern and inferior axis, suggestive of a right ventricular outflow tract (RVOT) focus rather than left ventricular scar due to LAD territory myocardial infarction (MI). Echocardiography showed normal wall motion. Angiography revealed a patent mid-LAD stent. Cardiac MRI with delayed postcontrast sequence revealed several regions of hyperenhancement abnormality within the basal portion of the interventricular septum...
June 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28666664/young-infants-with-severe-tetralogy-of-fallot-early-primary-surgery-versus-transcatheter-palliation
#20
Travis J Wilder, Glen S Van Arsdell, Lee Benson, Eric Pham-Hung, Michael Gritti, Alexandra Page, Christopher A Caldarone, Edward J Hickey
BACKGROUND: Infants with severe tetralogy of Fallot may undergo (1) early primary surgical repair (EARLY) or (2) early transcatheter palliation (CATH) before delayed surgical repair. We compared these strategies with (3) elective single-stage tetralogy of Fallot repair (IDEAL). METHODS: From 2000 to 2012, 453 children underwent tetralogy of Fallot repair (excluding systemic-pulmonary shunts), including 383 in the IDEAL (75%), 42 in the EARLY (9%), and 28 in the CATH (6%) groups...
May 19, 2017: Journal of Thoracic and Cardiovascular Surgery
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