scholarly journals Transfemoral Pulmonary Valve Implantation for Severe Pulmonary Insufficiency After Ross Procedure

2013 ◽  
Vol 61 (6) ◽  
pp. e143 ◽  
Author(s):  
Karl Stangl ◽  
Verena Stangl ◽  
Michael Laule
Keyword(s):  
Pulmonary Valve ◽  
Pulmonary Insufficiency ◽  
Ross Procedure ◽  
Valve Implantation ◽  
Pulmonary Valve Implantation

Abstract 3176: Percutaneous Pulmonary Valve Implantation Is A Successful Treatment Option For RVOT Conduit Failure After Ross Procedure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Johannes Nordmeyer ◽  
Philipp Lurz ◽  
Louise Coats ◽  
Fiona Walker ◽  
Andrew M Taylor ◽  
...  
Keyword(s):  
Treatment Option ◽  
Pulmonary Valve ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Ross Operation ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation

Background- The Ross operation offers good autograft function and low re-operation rates for the left ventricular outflow tract, however, the rate of conduit dysfunction in the right ventricular outflow tract (RVOT) remains a significant concern. Percutaneous pulmonary valve implantation (PPVI) is a novel trans-catheter treatment option for RVOT conduit dysfunction. Methods and Results- Of the 156 patients who underwent PPVI at our institutions with the current device, we retrospectively analyzed the outcomes of 11 patients (mean age: 26±5 years) who had RVOT conduit failure, 11.3±3.2 years following the Ross operation. PPVI could be performed in all patients (procedure time: 100±15 min; fluoroscopy time: 20±6 min). The RVOT gradient during catheterization and pulmonary regurgitant fraction (PRF) measured on magnetic resonance imaging (MRI) fell after PPVI (RVOT gradient: 35±6.5 mmHg to 14±2.8 mmHg, P<0.01; PRF: 18±6% to 3±2%, P<0.05). During mean follow-up of 17.4±5.2 months, there was 1 explantation (re-stenosis). The probability for freedom from RVOT re-operation was 100% at 1 year and 85.7% at 3 years. Conclusions- Failure of the conduit in the RVOT following Ross procedure can be successfully treated with PPVI to decrease the cumulative surgical burden in the lifetime management of congenital or acquired lesions of ventricular outflow tracts.

Acute and short-term haemodynamic impact of transcatheter pulmonary valve implantation on left ventricular systolic and diastolic function

2021 ◽  
pp. 1-7
Author(s):  
Ryan A. Romans ◽  
Wendy Whiteside ◽  
Sunkyung Yu ◽  
Lori Harris ◽  
Veronika Dottermann ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Pulmonary Valve ◽  
Pulmonary Stenosis ◽  
Ventricular Volume ◽  
Left Ventricular ◽  
Pulmonary Insufficiency ◽  
Systolic And Diastolic Function ◽  
Valve Implantation ◽  
Post Implantation ◽  
Pulmonary Valve Implantation

Abstract Objectives: Assess the acute and short-term haemodynamic impact of transcatheter pulmonary valve implantation on left ventricular systolic and diastolic function stratified by pre-transcatheter pulmonary valve implantation physiology. Background: Transcatheter pulmonary valve implantation is a widely available option to treat residual or recurrent pulmonary stenosis and pulmonary insufficiency. Transcatheter pulmonary valve implantation acutely increases pulmonary artery size and diastolic pressure in patients with pulmonary insufficiency and acute pulmonary edema has been reported after transcatheter pulmonary valve implantation, possibly related to acute left ventricular volume loading. However, the impact of transcatheter pulmonary valve implantation on left ventricular diastolic function has not been established. Methods: Patients who underwent transcatheter pulmonary valve implantation from 2010 to 2017 at our centre were grouped by indication for transcatheter pulmonary valve implantation as pulmonary stenosis, pulmonary insufficiency, or mixed disease. Separate analysis was performed on those who underwent transcatheter pulmonary valve implantation for pulmonary stenosis versus pulmonary insufficiency or mixed disease. Intracardiac haemodynamics immediately before and after transcatheter pulmonary valve implantation and echocardiographic assessment of left ventricular systolic and diastolic function at baseline, 1-day post transcatheter pulmonary valve implantation, and 1-year post transcatheter pulmonary valve implantation were compared between groups. Results: In 102 patients who underwent transcatheter pulmonary valve implantation, the indication was pulmonary stenosis in 29 (28%), pulmonary insufficiency in 28 (29%), and mixed disease in 44 (43%). There were no significant differences in left ventricular systolic or diastolic function between groups at baseline, immediately after transcatheter pulmonary valve implantation, or 1-year post implantation. The mean pulmonary artery wedge pressure increased equally across groups. Conclusions: While patients with pulmonary insufficiency likely have acute left ventricular volume loading following transcatheter pulmonary valve implantation, this does not appear to be haemodynamically significant as transcatheter pulmonary valve implantation was not associated with measurable changes in left ventricular systolic or diastolic function acutely or 1-year post implantation.

Coronary event after transcatheter pulmonary valve implantation

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
D Biermann ◽  
J Schönebeck ◽  
M Rebel ◽  
J Weil ◽  
H Reichenspurner ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Coronary Event ◽  
Valve Implantation ◽  
Pulmonary Valve Implantation

Percutaneous Pulmonary Valve Implantation in a Bangladeshi Center: A Case Series

2020 ◽  
Vol 28 (1) ◽  
pp. 1-6
Author(s):  
Fatema Nurun Nahar ◽  
Jufan Mansur Al ◽  
Shubert Stephan ◽  
Hossain Mir Mahmud
Keyword(s):  
Heart Disease ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Valve ◽  
Case Series ◽  
Military Hospital ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation

INTRODUCTION Incidence of congenital heart disease is 25 per thousand live birth in Bangladesh which is much higher than other countries. Tetralogy of Fallot, the commonest cyanotic heart disease (5%) and some other complex diseases with right ventricular outflow tract abnormality demand surgical correction and revision in many occasions including percutaneous intervention. As a resource constraint country, it was a difficult task to introduce percutaneous pulmonary valve implantation (PPVI) with MelodyTM. However, it was started on 12th December 2012 in Combined Military Hospital Dhaka, Bangladesh and cases performed till October 2019 were included in this series. METHODS Retrospective analysis of six cases who had PPVI with MelodyTM in Combined Military Hospital, Bangladesh. Patient with dysfunctional conduit between right ventricle (RV) and pulmonary artery causing (a) Symptoms of exceptional dyspnoea of various grade (NYHA II,III, IV) (b) RVEVD >150 ml/m2 ±regurgitant fraction >40% (c) RVOT peak instantaneous gradient > 30 mm Hg. (d) RV dysfunction (RVEF<40%) were accepted for the procedure and outcome were analyzed. RESULTS Mean age was 9.56 ± 2.96 years, weight was 28.75 ± 8.61 kg, height was 137.5 ± 17.52 cm. Mean age at surgery was 4.25 ± 2.72 years. Female were 66.66%. Aortic homograft was used in 66.66% cases. Eighteen mm Ensemble was used in four (66.66%) cases and 20 mm and 22 mm in one each. Immediate result was excellent with no residual PS in two cases and negligible residual flow acceleration across pulmonary valve in four cases. No PR seen in all except one. One patient developed Bacterial endocarditis after 3 years and was treated. CONCLUSION Aim of PPVI is to prolong the life expectancy of conduits which were placed surgically from right ventricle to pulmonary artery. In our case series, we found that Melody valve is functioning well without any complications like infective endocarditis or stent fracture. KEYWORDS PPVI, MelodyTM, RVOT, Outcome

scholarly journals Acute and mid-term outcomes of transcatheter pulmonary valve implantation in patients older than 40 years

2021 ◽  
Vol 3 ◽  
pp. 100084
Author(s):  
Osamah Aldoss ◽  
Kaitlin Carr ◽  
Shabana Shahanavaz ◽  
David Balzer ◽  
Daniel S. Levi ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Valve Implantation ◽  
Pulmonary Valve Implantation

#81: Care Process Measures and Outcomes of Percutaneous Pulmonary Valve Implantation-associated Infective Endocarditis

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S9-S9
Author(s):  
B Rubbab ◽  
C Talluto ◽  
A Nuibe ◽  
R Levorson
Keyword(s):  
Infective Endocarditis ◽  
Tetralogy Of Fallot ◽  
Median Duration ◽  
Pulmonary Valve ◽  
Coagulase Negative Staphylococcus ◽  
Elapsed Time ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation

Abstract Background Percutaneous pulmonary valve implantation (PPVI) is being increasingly used as a minimally invasive corrective procedure for right ventricular outflow tract (RVOT) dysfunction. Ten-year survival following PPVI is estimated at over 90% due to the durability of the various bioprosthetic valves. However, infective endocarditis (IE) remains a potential complication of such valves with significant morbidity and mortality. We evaluated the presenting symptoms, clinical features, pathogens, and outcomes of patients with IE following PPVI to identify opportunities to improve early diagnosis and management. Methods A convenience sample of patients at a large Pediatric Cardiology practice in Northern Virginia was queried for PPVI and IE from January 1, 2016, to June 30, 2019. Manual chart review was done to extract clinical points of interest and descriptive analyses were performed. Patients were classified as having IE per modified Duke’s criteria. Results We identified 14 patients who underwent PPVI. Five of these patients (36%) developed IE. All IE patients had underlying Tetralogy of Fallot and none had previous episodes of IE. 60% of patients with IE were male with a median age of 26 years old (IQR 20–30). Four IE patients had a Melody valve and 1 had a SAPIEN valve. The median elapsed time between PPVI and IE diagnosis was 128 days (IQR 32–391) with a median duration of illness prior to the diagnosis of IE of 6 days (IQR 5–9). All IE patients had to present fever. 40% of IE patients had to present chest pain and 20% had presenting musculoskeletal pain. All IE patients had an elevated initial C-reactive protein (CRP) with a median value of 13.1 mg/dL (IQR 12.5–15.2). The median initial white blood cell count was 9.3 × 103/μL (IQR 8.1–10.3). The median duration of bacteremia was 1 day (IQR 1–2). A pathogen was recovered in all five IE patients with different organisms amongst the patients: coagulase-negative Staphylococcus species were recovered in patients who developed IE within 60 days from PPVI (Staphylococcus lugdunensis and Staphylococcus epidermidis) whereas coagulase-negative Staphylococcus species and oral commensal organisms were found in IE patients beyond 60 days from PPVI (Staphylococcus sanguinis, Gamella haemolysans, and Neisseria elongata). The initial echocardiogram did not show vegetations in any of the patients and 40% went on to have sternotomy with valve replacement. There were no deaths. Conclusions With an increase in PPVI, clinicians should have a high index of suspicion for IE in patients with underlying Tetralogy of Fallot who present with fever and elevated CRP, regardless of elapsed time from PPVI or valve type. Empiric antimicrobial therapy for suspected IE following PPVI should remain broad with other possible pathogens beyond coagulase-negative Staphylococcus species.

scholarly journals Percutaneous Pulmonary Valve Implantation Alters Electrophysiologic Substrate

2016 ◽  
Vol 5 (10) ◽  
Author(s):  
Hoang H. Nguyen ◽  
Shabana Shahanavaz ◽  
George F. Van Hare ◽  
David T. Balzer ◽  
Ramzi Nicolas ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation
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