Regurgitation after Edwards SAPIEN valve implantation: truly paravalvular or ‘supra-skirtal’?

Abstract Background Transcatheter pulmonary valve implantation (TPVI) is an effective treatment for right ventricular outflow tract (RVOT) dysfunction. Patients affected by congenital heart disease requiring TPVI may have difficult anatomies, thus making the intervention technically demanding. Case summary We report a case series of two patients affected by RVOT dysfunction. Both the cases were characterized by difficulty to advance the valve over the wire, which was successfully overcome by the application of the snared wire technique (SWT) to TPVI. Discussion Various technical pitfalls and tips have been described to facilitate the delivery of the transcatheter Edwards Sapien valve in the pulmonary position. The SWT described by the authors may be a helpful tool to gain supportiveness and stability of the guidewire during the procedure.

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Initial experience with Edwards SAPIEN valve transcatheter implantation in native RVOT in Latvia

Acta medica Lituanica ◽

10.6001/actamedica.v27i1.4261 ◽

2020 ◽

Vol 27 (1) ◽

pp. 10-16

Author(s):

Luize Auzina ◽

Inguna Lubaua ◽

Elina Ligere ◽

Inga Lace ◽

Inta Bergmane ◽

...

Keyword(s):

Right Ventricle ◽

Pulmonary Valve ◽

Pulmonary Regurgitation ◽

Pulmonary Valve Replacement ◽

Landing Zone ◽

Edwards Sapien ◽

Edwards Sapien Valve ◽

The Right ◽

Valve Implantation ◽

Pulmonary Valve Implantation

Transcatheter pulmonary valve implantation has been a well-known method for more than a decade, but there are still many challenging cases when a personalized solution is needed. We report a case of a 15-year-old female patient with tetralogy of Fallot, who underwent a surgical correction during infancy. Because of progressive pulmonary regurgitation, stenosis, and right ventricle dilatation, transcatheter pulmonary valve implantation in the native right ventricle outflow tract (RVOT) using Edwards SAPIEN valve was performed. A “landing zone” was created prior to the intervention of stenting the RVOT and the right pulmonary artery. The transcatheter approach for pulmonary valve replacement in a native RVOT is a reasonable alternative to the surgical approach.

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Abstract 17302: A Meta-Analysis of Major Adverse Cardiovascular and Cerebrovascular Events in Patients Undergoing Transcatheter Aortic Valve Implantation Using Edwards SAPIEN valve versus Medtronic CoreValve for Severe Aortic Stenosis

Circulation ◽

10.1161/circ.130.suppl_2.17302 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Hemang B Panchal ◽

Neil Barry ◽

Samit Bhatheja ◽

Kais Albalbissi ◽

Timir Paul

Keyword(s):

Severe Aortic Stenosis ◽

Meta Analysis ◽

Transcatheter Aortic Valve ◽

Cerebrovascular Events ◽

Edwards Sapien ◽

All Cause Mortality ◽

Edwards Sapien Valve ◽

Medtronic Corevalve ◽

Aortic Valve Implantation ◽

Valve Implantation

Background: In patients with severe aortic stenosis (AS) who are at high risk for surgery, a transcatheter aortic valve implantation (TAVI) is an emerged alternative procedure using Edwards SAPIEN valve (EV) or Medtronic CoreValve (CV). The purpose of this meta-analysis is to compare early major adverse cardiovascular and cerebrovascular events (MACCE) between EV and CV. Methods: PubMed and the Cochrane Center Register of Controlled Trials were searched through May 2014. Seventeen studies (n=6211) comparing TAVI procedure that used EV (n=2693) and CV (n=3518) were included. End points were post-procedural all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, major bleeding and major vascular events. The odds ratio (OR) with 95% confidence interval (CI) was computed and p<0.05 was considered as a level of significance. Results: The studies were homogeneous for all outcomes except all-cause mortality. There was no significant difference between EV and CV for post-procedural all-cause mortality (OR: 0.82, CI: 0.6-1.13, p=0.23), cardiovascular mortality (OR: 0.7, CI: 0.41-1.2. p=0.2), myocardial infarction (OR: 1.13, CI: 0.51-2.51, p=0.76), stroke (OR: 0.97, CI: 0.66-1.42, p=0.86) (Figure), major bleeding (OR: 1.13, CI: 0.81-1.58, p=0.48) and major vascular complications (OR: 1.22, CI: 0.94-1.58, p=0.14). Conclusion: The results of our meta-analysis of 6211 patients suggest that the types of valve used to perform TAVI procedures do not affect early mortality and MACCE outcomes. Further studies are needed to evaluate long-term outcomes.

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