Right Ventricular Outflow Tract Septal Pacing: Long-Term Follow-Up of Ventricular Lead Performance

Abstract OBJECTIVES: The objective of this study was to evaluate our late outcomes using expanded polytetrafluoroethylene (ePTFE) valved patches with bulging sinuses and a fan-shaped valve for right ventricular outflow tract (RVOT) reconstruction. METHODS: Six hundred and ninety patients underwent RVOT reconstruction using fan-shaped ePTFE valves and ePTFE valved patches with a bulging sinus. The patients’ median age and weight were 1.3 years [range 4 days–64.2 years, interquartile range (IQR) 0.9–2.3 years] and 8.7 (range 2.8–83.1, IQR 7.4–10.5) kg, respectively. The patches were monocuspid in 634 patients, bicuspid in 49 patients and tricuspid in 7 patients. Preoperative and postoperative data were collected retrospectively from the patients’ medical records. The longest follow-up period was 17.5 (7.6 ± 3.9) years. RESULTS: There were no deaths related to the ePTFE patch. Pulmonary insufficiency was less than mild in 77.3%, and the peak RVOT gradient was <36 mmHg in 92.3% at the latest follow-up. Redo of RVOT reconstruction was performed in 40 patients, in no cases because of patch infection. Overall freedom from reoperation at 5, 10 and 15 years was 96.5%, 93.1% and 87.9%, respectively; by patient age, the rates at 5, 10 and 15 years for those younger than 1 year were 93.2%, 91.0% and 88.9%, respectively, while for those 1 year or older, they were 97.9%, 94.0% and 88.3%, respectively. CONCLUSIONS: Satisfactory long-term outcomes were achieved with ePTFE patches with a bulging sinus and a fan-shaped valve. This ePTFE valved patch could be the optimal choice for RVOT reconstruction.

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Different characteristics and electrophysiological properties between early and late recurrences after acute successful catheter ablation of idiopathic right ventricular outflow tract arrhythmias during long-term follow-up

Heart Rhythm ◽

10.1016/j.hrthm.2014.06.011 ◽

2014 ◽

Vol 11 (10) ◽

pp. 1760-1769 ◽

Cited By ~ 9

Author(s):

Fa-Po Chung ◽

Eric Chong ◽

Yenn-Jiang Lin ◽

Shih-Lin Chang ◽

Li-Wei Lo ◽

...

Keyword(s):

Catheter Ablation ◽

Right Ventricular ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Electrophysiological Properties ◽

Long Term Follow Up ◽

Outflow Tract Arrhythmias ◽

Different Characteristics

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The long-term efficacy of an ablation procedure in patients with low LV ejection fraction and ventricular tachyarrhythmias originated from right ventricular outflow tract

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2014-1-11-13 ◽

2015 ◽

Vol 18 (1) ◽

pp. 11

Author(s):

V. A. Sakovich ◽

A. G. Strelnikov ◽

V. V. Shabanov ◽

R. T. Kamiev ◽

A. B. Romanov ◽

...

Keyword(s):

Ejection Fraction ◽

Right Ventricular ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Ventricular Tachyarrhythmias ◽

Ablation Procedure ◽

Long Term Follow Up ◽

Lv Ejection Fraction

The aim of this prospective observational study was to assess efficacy and safety of the ablation procedure in patients with low LV ejection fraction (LVEF) and ventricular tachyarrhythmias originated from right ventricular outflow tract (RVOT) during long-term follow up. Fifty four consecutive patients with symptomatic premature ventricular complexes (PVC) or ventricular tachycardias (VT) with left bundle branch block (LBBB) pattern, inferior axis morphology and transition zone predominantly in V3-V4 were included in this study. The patients were followed up during 36 months after ablation procedure. The mean follow up period was 42.26 months. The long-term efficacy after one ablation procedure was 94.4% (51 patients) and after redo procedures - 98.1 % (53 patients). The LVEF increased from 422 at baseline to 565% after 36 months of follow up (p = 0.001). Radiofrequency catheter ablation in patients with low LVEF and ventricular tachyarrhythmias originated from RVOT is a safe and highly effective treatment during long-term follow up.

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Long-Term Follow-Up in Patients with Right Ventricular Outflow Tract Tachycardia and Arrhythmogenic Right Ventricular Cardiomyopathy Who Underwent Catheter Ablation

Journal of Arrhythmia ◽

10.4020/jhrs.27.sy07_4 ◽

2011 ◽

Vol 27 (Supplement) ◽

pp. SY07_4

Author(s):

Yenn-Jiang Lin ◽

Shih-Ann Chen

Keyword(s):

Right Ventricular ◽

Arrhythmogenic Right Ventricular Cardiomyopathy ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Ventricular Cardiomyopathy ◽

Ventricular Outflow Tract Tachycardia ◽

Long Term Follow Up ◽

Outflow Tract Tachycardia

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Tetralogy of Fallot: stent palliation or neonatal repair?

Cardiology in the Young ◽

10.1017/s1047951121000846 ◽

2021 ◽

pp. 1-9

Author(s):

Adeolu Banjoko ◽

Golnoush Seyedzenouzi ◽

James Ashton ◽

Fatemeh Hedayat ◽

Natalia N. Smith ◽

...

Keyword(s):

Pulmonary Artery ◽

Right Ventricular ◽

Tetralogy Of Fallot ◽

Surgical Repair ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Hospital Length Of Stay ◽

Mortality And Morbidity

Abstract Surgical repair of Tetralogy of Fallot has excellent outcomes, with over 90% of patients alive at 30 years. The ideal time for surgical repair is between 3 and 11 months of age. However, the symptomatic neonate with Tetralogy of Fallot may require earlier intervention: either a palliative intervention (right ventricular outflow tract stent, ductal stent, balloon pulmonary valvuloplasty, or Blalock-Taussig shunt) followed by a surgical repair later on, or a complete surgical repair in the neonatal period. Indications for palliation include prematurity, complex anatomy, small pulmonary artery size, and comorbidities. Given that outcomes after right ventricular outflow tract stent palliation are particularly promising – there is low mortality and morbidity, and consistently increased oxygen saturations and increased pulmonary artery z-scores – it is now considered the first-line palliative option. Disadvantages of right ventricular outflow tract stenting include increased cardiopulmonary bypass time at later repair and the stent preventing pulmonary valve preservation. However, neonatal surgical repair is associated with increased short-term complications and hospital length of stay compared to staged repair. Both staged repair and primary repair appear to have similar long-term mortality and morbidity, but more evidence is needed assessing long-term outcomes for right ventricular outflow tract stent palliation patients.

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