Electrocardiographic characteristics of the right ventricle following hemodynamic improvement after percutaneous pulmonary valve implantation, one year follow-up

2014 ◽  
Vol 47 (5) ◽  
pp. 612-617 ◽  
Author(s):  
Ewa Piotrowicz ◽  
Elżbieta Katarzyna Biernacka ◽  
Magdalena Mazgaj ◽  
Aneta Fronczak ◽  
Marcin Demkow ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Pulmonary Valve ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Hemodynamic Improvement ◽  
One Year ◽  
The Right ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
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

Management of balloon rupture during a percutaneous pulmonary valve implantation procedure

2018 ◽  
Vol 28 (10) ◽  
pp. 1168-1170 ◽  
Author(s):  
Alessia Faccini ◽  
Massimo Chessa ◽  
Mansour Aljoufan
Keyword(s):  
Right Ventricle ◽  
Pulmonary Valve ◽  
Outflow Tract ◽  
Alternative Procedure ◽  
Landing Zone ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Implantation Procedure ◽  
Pulmonary Valve Implantation

AbstractPercutaneous pulmonary valve implantation is increasingly adopted as an alternative procedure to surgery in dysfunctional homograft, and in patients with “native” or wide right ventricle outflow tract dysfunction. Pre-stenting is mandatory in this category of patients for many reasons, one of which is to create an adequate landing zone for the bioprosthesis. Here we report on a tricky situation that occurred during pre-stenting, and we describe how we successfully overcame it.

Baseline intracardiac echocardiography predicts haemodynamic changes and Doppler velocity patterns during follow-up after percutaneous pulmonary valve implantation

2021 ◽  
pp. 1-7
Author(s):  
Gareth J. Morgan ◽  
Salvador A. Rodriguez ◽  
Ryan Leahy ◽  
Jess Randall ◽  
Jenny E. Zablah
Keyword(s):  
Pulmonary Valve ◽  
Intracardiac Echocardiography ◽  
Doppler Velocity ◽  
Post Procedure ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Starting Point ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation

Abstract Background: Intracardiac echocardiography Doppler-derived gradients have previously been shown to correlate with post-procedure echocardiographic evaluations when compared with invasive gradients measured during percutaneous pulmonary valve implantation, suggesting that intracardiac echocardiography could offer an accurate and predictable starting point to estimate valve function after percutaneous pulmonary valve implantation. Methods: We performed a retrospective chart review of 51 patients who underwent percutaneous pulmonary valve implantation between September 2018 and December 2019 in whom intracardiac echocardiography was performed immediately after valve implantation. We evaluated the correlation between intracardiac echocardiography gradients and post-procedural Doppler-derived gradients. Among the parameters assessed, those which demonstrated the strongest correlation were used to create a predictive model of expected echo-derived gradients after percutaneous pulmonary valve implantation. The equation was validated on the same sample data along with a subsequent cohort of 25 consecutive patients collected between January 2020 and July 2020. Results: All the assessed correlation models between intracardiac echocardiography evaluation and post-procedure transthoracic echocardiographic assessments were statistically significant, presenting moderate to strong correlations. The strongest relationship was found between intracardiac echocardiography mean gradients and post-procedural transthoracic echocardiographic mean gradients. Therefore, an equation was created based on the intracardiac echocardiography-derived mean gradient, to allow prediction of the post-procedural and follow-up transthoracic echocardiographic-derived mean gradients within a range of ±5 mmHg from the observed value in more than 80% of cases. Conclusions: There is a strong correlation between intracardiac echocardiography and post-procedure transthoracic echocardiographic. This allowed us to derive a predictive equation that defines the expected transthoracic echocardiographic Doppler-derived gradient following the procedure and at out-patient follow-up after percutaneous pulmonary valve implantation.

scholarly journals Coronary Artery Anomalies and Their Impact on the Feasibility of Percutaneous Pulmonary Valve Implantation

2021 ◽  
Author(s):  
Anja Hanser ◽  
Jörg Michel ◽  
Andreas Hornung ◽  
Ludger Sieverding ◽  
Michael Hofbeck
Keyword(s):  
Coronary Artery ◽  
Pulmonary Valve ◽  
Single Coronary Artery ◽  
Coronary Artery Anomalies ◽  
Landing Zone ◽  
Percutaneous Pulmonary Valve Implantation ◽  
The Right ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve ◽  
Pulmonary Valve Implantation

AbstractOne of the major obstacles preventing successful percutaneous pulmonary valve implantation (PPVI) is related to the close proximity of coronary artery branches to the expected landing zone. The aim of this study was to assess the frequency of coronary artery anomalies (CAAs) especially those associated with major coronary branches crossing the right ventricular outflow tract (RVOT) and to describe their relevance for the feasibility of percutaneous pulmonary valve implantation (PPVI). In our retrospective single-center study 90 patients were evaluated who underwent invasive testing for PPVI in our institution from 1/2010 to 1/2020. CAAs were identified in seven patients (8%) associated with major branches crossing the RVOT due to origin of the left anterior descending (LAD) or a single coronary artery from the right aortic sinus. In 5/7 patients with CAAs balloon testing of the RVOT and selective coronary angiographies revealed a sufficiently large landing zone distal to the coronary artery branch. While unfavorable RVOT dimensions prevented PPVI in one, PPVI was performed successfully in the remaining four patients. The relatively short landing zone required application of the “folded” melody technique in two patients. All patients are doing well (mean follow-up 3 years). CAAs associated with major coronary branches crossing the RVOT can be expected in about 8% of patients who are potential candidates for PPVI. Since the LAD crossed the RVOT below the plane of the pulmonary valve successful distal implantation of the valve was possible in 4/7 patients. Therefore these coronary anomalies should not be considered as primary contraindications for PPVI.

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