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Percutaneous pulmonary valve

Wail Alkashkari, Amani Alsubei, Ziyad M Hijazi
PURPOSE OF REVIEW: The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction...
March 15, 2018: Current Cardiology Reports
Stanimir Georgiev, Daniel Tanase, Peter Ewert, Christian Meierhofer, Alfred Hager, Jelena Pabst von Ohain, Andreas Eicken
BACKGROUND: To investigate the feasibility and mid-term results of percutaneous pulmonary valve implantation (PPVI) in patients with conduit free or "native" right ventricular outflow tracts (RVOT). METHODS AND RESULTS: We identified all 18 patients with conduit free or "native" right ventricular outflow tract, who were treated with percutaneous pulmonary valve implantation (PPVI) in our institution. They were divided into two groups - these in whom the central pulmonary artery was used as an anchoring point for the preparation of the landing zone (n=10) for PPVI and these, in whom a pulmonary artery branch was used for this purpose (n=8)...
May 1, 2018: International Journal of Cardiology
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Sophie Malekzadeh-Milani, Ali Houeijeh, Zakaria Jalal, Sébastien Hascoet, Mohamed Bakloul, Philippe Aldebert, Jean-François Piéchaud, François Heitz, Helene Bouvaist, Claire Dauphin, Patrice Guérin, Olivier Villemain, Jérome Petit, François Godart, Jean-Benoit Thambo, Younes Boudjemline
BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is a routine treatment for dysfunctional right ventricular outflow tract. Infective endocarditis (IE) is a major concern. AIM: To report French experience with the Melody™ valve (Medtronic Inc., Minneapolis, MN, USA). METHODS: All patients who underwent PPVI were recorded in a multicentre French national survey. Demographic and procedural data were collected from patients with IE...
March 9, 2018: Archives of Cardiovascular Diseases
Y J Zhang, X Pan, C Wang
No abstract text is available yet for this article.
February 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Alessia Faccini, Luca Giugno, Mario Carminati, Gianfranco Butera
No abstract text is available yet for this article.
February 16, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Endale Tefera, Mohamed Leye, Patrick Garceau, Denis Bouchard, Joaquim Miró
BACKGROUND: The Inoue balloon technique is the standard technique for mitral valve balloon commissurotomy at this stage. However, the hardware for this technique is expensive and may not always be available in resource-limited settings. OBJECTIVE: This article reports our experience with percutaneous transmitral balloon commissurotomy using a single balloon (Nucleus) with arteriovenous loop stabilisation. METHOD: Eleven young patients, aged 12-26 years and weighing 23-48 kg, underwent transmitral balloon commissurotomy using the described technique at our centre from April to May 2014...
February 19, 2018: Cardiovascular Journal of Africa
Ahmed Kheiwa, Punag Divanji, Vaikom S Mahadevan
Right ventricular outflow tract (RVOT) dysfunction is a common hemodynamic challenge for adults with congenital heart disease (ACHD), including patients with repaired tetralogy of Fallot (TOF), truncus arteriosus (TA), and those who have undergone the Ross procedure for congenital aortic stenosis and the Rastelli repair for transposition of great vessels. Pulmonary valve replacement (PVR) has become one of the most common procedures performed for ACHD patients. Areas covered: Given the advances in transcatheter technology, we conducted a detailed review of the available studies addressing the indications for PVR, historical background, evolving technology, procedural aspects, and the future direction, with an emphasis on ACHD patients...
March 2018: Expert Review of Cardiovascular Therapy
Nicholas S Clarke, Howaida El-Said, John J Lamberti, Raghav A Murthy
Percutaneous therapies for congenital heart disease have been evolving rapidly despite limited investment from industry. The Melody transcatheter pulmonary valve (Medtronic, Inc, Minneapolis, MN USA) replacement therapy represents an important advancement in this arena. It has been approved in the United States for use in the pulmonary position, on a Humanitarian Device Exemption status. Off-label use of the Melody transcatheter pulmonary valve has extended to the mitral, pulmonary, and aortic valves, especially in previously implanted valves with prosthetic valve degeneration...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Katarzyna Gendera, Peter Ewert, Andreas Eicken
We report on successful endovascular retrieval of an accidentally flared Melody valve in an adult patient with an indication for percutaneous pulmonary valve implantation. The Melody valve was removed through a 24 F sheath, introduced via the right jugular vein, and the urgent open-heart surgery was avoided.
February 7, 2018: Cardiology in the Young
Alessia Faccini, Gianfranco Butera
Nowadays, percutaneous pulmonary valve implantation (PPVI) is a suitable alternative to surgical procedure in patients with right ventricle outflow tract dysfunction. Two valves are currently available for PPVI: the Melody valve and the Edwards Sapien valve. The following complications may occur: coronary artery compression, deformation of the aortic root, stent or valve embolization, damage of distal pulmonary arteries, access site injuries. Here, we report on three cases of severe tricuspid regurgitation due to valvular and subvalvular apparatus damage during Edwards Sapien XT valve implantation...
February 6, 2018: Catheterization and Cardiovascular Interventions
Marc Eugène, Marina Urena, Jérémie Abtan, José-Luis Carrasco, Walid Ghodbane, Patrick Nataf, Alec Vahanian, Dominique Himbert
The prognosis of patients with cardiogenic shock (CS) or refractory pulmonary edema because of severe aortic stenosis remains poor. The purpose of this study was to assess the outcomes of rescue percutaneous balloon aortic valvuloplasty (PBAV) in the transcatheter aortic valve implantation (TAVI) era. Patients were consecutively included between 2008 and 2016. CS was defined as ≥1 sign of systemic hypoperfusion and need of catecholamines. Refractory pulmonary edema was defined as not controlled by optimal medical treatment...
December 29, 2017: American Journal of Cardiology
Yong Yang, Xi Li, Mao Chen, Yuan Feng
RATIONALE: Iatrogenic atrial septal defects caused by cardiac surgery are rare complications that are traditionally repaired through reoperations; unfortunately, reoperations are accompanied by high risk and trauma. PATIENT CONCERNS: Herein, we report a rare case of a huge atrial septal defect after mitral and aortic mechanical valve replacement. DIAGNOSES: Transesophageal echocardiography revealed a 20 × 33 mm atrial septal defect with a mainly left-to-right shunt and bidirectional shunt...
December 2017: Medicine (Baltimore)
Yahan Liu, Zhipeng Wang, Jing Li, Yiqian Ban, Guangmei Mao, Man Zhang, Mo Wang, Yan Liu, Beilei Zhao, Qiang Shen, Qingbo Xu, Nanping Wang
BACKGROUND: As a monoamine neurotransmitter, 5-hydroxytryptamine (5-HT) or serotonin modulates mood, appetite, and sleep. Besides, 5-HT also has important peripheral functions. 5-HT receptor 2B (5-HT2BR) plays a key role in cardiovascular diseases, such as pulmonary arterial hypertension and cardiac valve disease. Percutaneous intervention has been used to restore blood flow in occlusive vascular disease. However, restenosis remains a significant problem. Herein, we investigated the role of 5-HT2BR in neointimal hyperplasia, a key pathological process in restenosis...
January 30, 2018: Journal of the American Heart Association
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Minh Trí Nhân Nguyễn, Nicolas Foin
OBJECTIVES: We assess the mid-term outcomes of ultrathin biodegradable polymer double stenting using a very minimal crushing (Nano-Crush) technique in large complex coronary bifurcation. BACKGROUND: Complex bifurcations have been suggested to be better approached by a planned double stent technique. METHODS: Two hundred and five consecutive patients (107 males and 98 females) referred for large complex coronary bifurcation percutaneous coronary interventions were enrolled...
January 25, 2018: Catheterization and Cardiovascular Interventions
Daniel Kretzschmar, Alexander Lauten, Harald Schubert, Sabine Bischoff, Christian Schulze, Markus W Ferrari
AIMS: Mechanical right ventricular (RV) support offers a treatment option for critically ill patients with RV failure (RVF). We developed an assist device for rapid percutaneous implantation. METHODS AND RESULTS: The PERKAT® RV ("PERkutane KATheterpumptechnologie") device consists of a nitinol chamber covered by foils containing inflow valves. An outlet tube is attached to its distal part. The system is designed for 18F percutaneous implantation. The chamber is unfolded in the inferior vena cava while the outlet tube bypasses the right heart with the tip in the pulmonary trunk...
January 23, 2018: EuroIntervention
Claudio Capelli, Emilie Sauvage, Giuliano Giusti, Giorgia M Bosi, Hopewell Ntsinjana, Mario Carminati, Graham Derrick, Jan Marek, Sachin Khambadkone, Andrew M Taylor, Silvia Schievano
Patient-specific computational models have been extensively developed over the last decades and applied to investigate a wide range of cardiovascular problems. However, translation of these technologies into clinical applications, such as planning of medical procedures, has been limited to a few single case reports. Hence, the use of patient-specific models is still far from becoming a standard of care in clinical practice. The aim of this study is to describe our experience with a modelling framework that allows patient-specific simulations to be used for prediction of clinical outcomes...
February 6, 2018: Interface Focus
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
Sebastien Hascoet, José Diogo Martins, Haysam Baho, Saule Kadirova, Fatima Pinto, Florent Paoli, Fadi Bitar, Abdelfatah Abu Haweleh, Anselm Uebing, Philippe Acar, Olivier Ghez, Alain Fraisse
BACKGROUND: Guidelines allow percutaneous pulmonary valve implantation (PPVI) in conduits above 16mm diameter. Balloon dilatation of a conduit to a diameter>110% of the original implant size is also not recommended. We analyzed patients undergoing PPVI in such conditions. METHODS AND RESULTS: Nine patients (May 2008-July 2016) from 8 institutions underwent PPVI in conduits <16mm diameter. Five patients with 16-18mm conduit diameter underwent PPVI after over-expansion of the conduit>110%...
December 5, 2017: International Journal of Cardiology
Hossam Abubakar, Ahmed Rashed, Ahmed Subahi, Ahmed S Yassin, Mohamed Shokr, Mahir Elder
AngioVac is a vacuum-based device approved in 2014 for percutaneous removal of undesirable materials from the intravascular system. Although numerous reports exist with regard to the use of the AngioVac device in aspiration of iliocaval, pulmonary, upper extremity, and right-sided heart chamber thrombi, very few data are present demonstrating its use in treatment of right-sided endocarditis. In this case report, we describe the novel device used in debulking a large right-sided tricuspid valve vegetation reducing the occurrence of septic embolisation and enhancing the efficacy of antibiotics in clearance of bloodstream infection...
2017: Case Reports in Cardiology
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