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Right ventricular outflow tract stenting

Alessandro Frigiola, Francesca Romana Pluchinotta, Antonio Saracino, Alessandro Giamberti, Carmelo Arcidiacono, Luciane Piazza, Matteo Reali, Gianfranco Butera, Alessandro Varrica, Mario Carminati
AIMS: Paediatric patients with mitral valve (MV) disease have limited options for prosthetic MV replacement. Based on a long experience with the stented bovine jugular vein graft (Melody Valve) in the right ventricular outflow tract, we tested the use of the Melody Valve as a surgical implant in the mitral position in patients with congenital mitral disease. METHODS AND RESULTS: Eight patients, age 3 months to 6.2 years, with congenital MV dysplasia had undergone Melody valve implantation in mitral position between March 2014 and October 2015...
January 3, 2017: EuroIntervention
Andrew C Glatz
No abstract text is available yet for this article.
December 2016: Circulation. Cardiovascular Interventions
Juan Pablo Sandoval, Rajiv R Chaturvedi, Lee Benson, Gareth Morgan, Glen Van Arsdell, Osami Honjo, Christopher Caldarone, Kyong-Jin Lee
BACKGROUND: Tetralogy of Fallot with cyanosis requiring surgical repair in early infancy reflects poor anatomy and is associated with more clinical instability and longer hospitalization than those who can be electively repaired later. We bridged symptomatic infants with risk factors for early primary repair by right ventricular outflow tract stenting (stent). METHODS AND RESULTS: Four groups of tetralogy of Fallot with confluent central pulmonary arteries were studied: stent group (n=42), primary repair (aged <3 months) with pulmonary stenosis (early-PS group; n=44), primary repair (aged <3 months) with pulmonary atresia (early-PA group; n=49), and primary repair between 3 and 11 months of age (surg>3mo group; n=45)...
December 2016: Circulation. Cardiovascular Interventions
James A Kuo, Ashlea A Feezel, Traci N Putnam, Deborah A Schutte
BACKGROUND: The Melody transcatheter pulmonary valve has been implanted successfully worldwide since its first implant in 2000. The vast majority of these valves have been implanted in pulmonary homografts. In our institution, the most common valve used for pulmonary valve replacement is the Medtronic Freestyle stentless porcine aortic heterograft. OBJECTIVE: We describe our experience implanting the Melody valve within the Freestyle heterograft. METHODS: Retrospective chart review was performed...
November 26, 2016: Catheterization and Cardiovascular Interventions
Patcharapong Suntharos, Lourdes R Prieto
Percutaneous pulmonary valve implantation is now an acceptable treatment option. The Edwards SAPIEN valve, intended for transcatheter aortic valve implantation, has been used in patients whose landing zone diameter is >22 to 24 mm which is not suitable for Melody valve. We report a patient in whom we successfully placed the latest generation, Edwards SAPIEN 3 (ES3) in the pulmonary position. However, because of the short covered portion of this valve, there was a significant paravalvular leak through the stent struts requiring implantation of a second ES3 valve...
November 18, 2016: World Journal for Pediatric & Congenital Heart Surgery
Victor Mauri, Andreas Reimann, Daniel Stern, Maximilian Scherner, Elmar Kuhn, Volker Rudolph, Stephan Rosenkranz, Kaveh Eghbalzadeh, Kai Friedrichs, Thorsten Wahlers, Stephan Baldus, Navid Madershahian, Tanja K Rudolph
OBJECTIVES: The aim of this study was to identify predictors of permanent pacemaker implantation (PPMI) following transcatheter aortic valve replacement (TAVR) with a balloon-expandable transcatheter valve (Edwards SAPIEN 3). BACKGROUND: New-onset conduction disturbances requiring PPMI remain a major concern following TAVR. Predictors are not yet well defined. METHODS: The influence of angiographic implantation depth, device landing zone calcium volume, oversizing, pre- and post-dilation, and baseline conduction disturbances on PPMI rate was analyzed in 229 patients undergoing TAVR with the SAPIEN 3 device...
November 14, 2016: JACC. Cardiovascular Interventions
Ewelina Kwaśniak, Ireneusz Haponiuk, Maciej Chojnicki, Radosław Jaworski, Aneta Szofer-Sendrowska, Mariusz Steffens
No abstract text is available yet for this article.
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Christian Buchholz, Andreas Mayr, Ariawan Purbojo, Martin Glöckler, Okan Toka, Robert A Cesnjevar, André Rüffer
OBJECTIVES: This retrospective single-centre review presents mid- and long-term results of stented biological valves (SBVs) in the pulmonary position. METHODS: Fifty-two SBVs (17 Carpentier-Edwards Supraannular; 13 Carpentier-Edwards Perimount; 12 St. Jude Medical Trifecta; 4 Sorin Mitroflow; 4 Sorin Soprano; 2 Sorin More) were implanted between 2000 and 2015. The median valve size, patient age and weight were 23 mm (range 19-27), 22.8 years (range 5-77) and 62...
December 2016: Interactive Cardiovascular and Thoracic Surgery
Joanna Nozynska, Brigitte Stiller, Jochen Grohmann
Reconstructing the right ventricular outflow tract and pulmonary valve via a bovine-derived valve conduit such as Matrix-P-Xenograft is a common surgical repair technique for pulmonary atresia and ventricular septal defect. After conduit degeneration due to calcification or aneurysmal dilatation, percutaneous transvenous stenting of the right ventricular outflow tract followed by pulmonary valve implantation has become the standard interventional treatment. Applied to stenotic conduits, the method is considered safe and effective...
June 1, 2016: Catheterization and Cardiovascular Interventions
Eimear McGovern, Conall T Morgan, Paul Oslizlok, Damien Kenny, Kevin P Walsh, Colin J McMahon
We retrospectively reviewed all the children with right ventricular outflow tract obstruction, hypoplastic pulmonary annulus, and pulmonary arteries who underwent stenting of the right ventricular outflow tract for hypercyanotic spells at our institution between January, 2008 and December, 2013; nine patients who underwent cardiac catheterisation at a median age of 39 days (range 12-60 days) and weight of 3.6 kg (range 2.6-4.3 kg) were identified. The median number of stents placed was one stent (range 1-4)...
October 2016: Cardiology in the Young
J Bugeja, V Grech, J V DeGiovanni
No abstract text is available yet for this article.
July 2015: Images in Paediatric Cardiology
Alistair B M Phillips, Phillip Nevin, Avni Shah, Vincent Olshove, Ruchira Garg, Evan M Zahn
BACKGROUND: Transcatheter pulmonary valve replacement (tPVR) is an accepted therapy for treatment of dysfunctional right ventricular outflow tract (RVOT) conduits. At present, the majority of Fallot patients who undergo transannular patch (TAP) repair are not candidates for tPVR due to the large irregular nature of their RVOT. Herein, we describe a novel approach to assessing the RVOT in this group, which may then be used to design, test, and carry out hybrid RVOT modification and transcatheter valve implantation in this population...
February 15, 2016: Catheterization and Cardiovascular Interventions
Ralf J Holzer, Ziyad M Hijazi
BACKGROUND: The number of patients undergoing transcatheter pulmonary valve replacement has been steadily increasing, resulting in many research projects focusing on this patient population. This has highlighted the need to summarize the currently available data. METHODS: A review of the literature was conducted and the results summarized. RESULTS: At present, the two commercially available valves approved for transcatheter pulmonary valve replacement include the Edwards Sapien valve and the Medtronic Melody valve...
January 1, 2016: Catheterization and Cardiovascular Interventions
Omar K Khalique, Nadira B Hamid, Susheel K Kodali, Tamim M Nazif, Leo Marcoff, Jean-Michel Paradis, Mathew R Williams, Torsten P Vahl, Isaac George, Martin B Leon, Rebecca T Hahn
BACKGROUND: Echocardiographic calculation of effective orifice area (EOA) after transcatheter aortic valve replacement is integral to the assessment of transcatheter heart valve (THV) function. The aim of this study was to determine the most accurate method for calculating the EOA of the Edwards SAPIEN and SAPIEN XT THVs. METHODS: One hundred intraprocedural transesophageal echocardiograms were analyzed. To calculate the post-transcatheter aortic valve replacement left ventricular outflow tract (LVOT) stroke volume (SV), four diameters were measured using two-dimensional echocardiography: (1) baseline LVOT diameter (LVOTd_PRE), (2) postimplantation LVOT diameter, (3) native aortic annular diameter, and (4) THV in-stent diameter...
November 2015: Journal of the American Society of Echocardiography
Matthew J Gillespie, Doff B McElhinney, Jacqueline Kreutzer, William E Hellenbrand, Howaida El-Said, Peter Ewert, John F Rhodes, Lars Søndergaard, Thomas K Jones
BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review of databases from 3 prospective Melody TPV (Medtronic Inc, Minneapolis, MN) trials. RESULTS: Among 358 patients who were catheterized with the intent to implant a Melody TPV for RVOT conduit stenosis or regurgitation (PR) as part of 3 prospective multicenter studies, 67 (19%) had a prior Ross procedure...
September 2015: Annals of Thoracic Surgery
Brieann Muller, Hani Ghawi, Mary G Heitschmidt, Louis Fogg, John Hibbeln, Ziyad M Hijazi, Damien Kenny
OBJECTIVE: Distortion of transcatheter heart valve (THV) stent shape and morphology has been shown to impact on THV function. This study sought to evaluate the relationship between geometrical CT follow-up data and consequent valve function in patients undergoing transcatheter pulmonary valve replacement with the Edwards SAPIEN THV. METHODS: All patients were enrolled in the COMPASSION trial. Multidetector computed tomography (MDCT) was performed as part of the study protocol at 6 months and yearly thereafter following valve implantation...
February 15, 2016: Catheterization and Cardiovascular Interventions
Juan-Miguel Gil-Jaurena, José-Luis Zunzunegui, Ramón Pérez-Caballero, Ana Pita, María-Teresa González-López, Fernando Ballesteros, Alejandro Rodríguez, Constancio Medrano
Complex cases undergo step surgical and percutaneous procedures, including stent deployment. Concerns arise on stent removal at latest surgery. Our initial experience is presented. Forty-six stents in 35 patients were partially or totally removed at surgery. Univentricular heart was diagnosed in 20 patients. Stents were previously deployed in: ductus (6), right ventricle outflow tract (12), atrial septal defect (4), right pulmonary artery (4), left pulmonary artery (16), inferior vena cava (2), superior vena cava (1) and ascending aorta (1)...
December 2015: Pediatric Cardiology
Worakan Promphan, Pimpak Prachasilchai, Suvipaporn Siripornpitak, Shakeel A Qureshi, Thanarat Layangool
BACKGROUND: At present, the exclusion for percutaneous pulmonary valve implantation for free pulmonary regurgitation after tetralogy of Fallot repair includes an unfavourably large right ventricular outflow tract. OBJECTIVE: To report feasibility and early experience with a recently developed transcatheter heart valve, Venus P-valveTM, implanted in six patients with severe pulmonary regurgitation with large right ventricular outflow tracts. Patients There were two female patients and four male patients...
April 2016: Cardiology in the Young
Elżbieta Katarzyna Biernacka, Witold Rużyłło, Marcin Demkow, Mirosław Kowalski, Mateusz Śpiewak, Walerian Piotrowski, Mariusz Kuśmierczyk, Sławomir Banaś, Jacek Różanski, Piotr Hoffman
OBJECTIVE: The aim of this study was to determine early and long-term results after transcatheter pulmonary valve implantation (TPVI) performed with the use of Medtronic Melody and Edwards Sapien valves in patients with full conduit or patched right ventricular outflow tract (RVOT) dysfunction. METHODS AND RESULTS: The study comprised 40 consecutive patients (full conduit, n = 25; RVOT patch, n = 15) who underwent TPVI between December 2008 and April 2012. TPVI was successfully performed in 37 patients (92...
June 2015: Journal of Invasive Cardiology
Nabil Hussein, Sombul Qamar, Qamar Abid
Aspergillus infections such as Aspergillus endocarditis were once relatively rare occurrences, however, due to the increased use of intracardiac devices, the incidence has grown. With mortality rates close to 100%, in medically treated cases, it is paramount that early diagnosis and treatment are performed. An immunocompetent aviculturist presented 8 months post aortic root replacement for severe aortic regurgitation with a composite graft, with central crushing chest pain. Investigations confirmed ST elevation inferior myocardial infarction due to stenosis of the origin of the right coronary artery, which was stented...
2015: BMJ Case Reports
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