scholarly journals Transcatheter surgery of residual right ventricular outflow tract stenosis

2021 ◽  
Vol 26 (8) ◽  
pp. 4125
Author(s):  
K. A. Rzayeva ◽  
A. V. Gorbatykh ◽  
I. Yu. Zhuravleva ◽  
I. A. Soinov ◽  
A. V. Voitov ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pulmonary Regurgitation ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Good Alternative ◽  
Outflow Tract ◽  
Term Survival ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Novel Method ◽  
Valve Implantation

Over the past 40 years, various types of prostheses have been developed for right ventricular outflow tract reconstruction. However, conduit stenosis and insufficiency due to valve degeneration occur frequently, decreasing the lifetime of patients. Transcatheter stenting of conduits does not always give favorable results and can lead to severe pulmonary regurgitation. The novel method of percutaneous pulmonary valve implantation is a good alternative to the surgical intervention according to data on long-term survival and quality of life.

First experiences with Myval Transcatheter Heart Valve System in the treatment of severe pulmonary regurgitation in native right ventricular outflow tract and conduit dysfunction

2021 ◽  
pp. 1-7
Author(s):  
Ender Odemis ◽  
Irem Yenidogan
Keyword(s):  
Right Ventricular ◽  
Pulmonary Valve ◽  
Pulmonary Regurgitation ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Valve System ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve

Abstract The rate of morbidity and mortality related to pulmonary regurgitation and pulmonary stenosis are big concerns after the surgery for CHD. Percutaneous pulmonary valve implantation has been established as a less invasive technique compared to surgery with promising results according to long-term follow-up of the patients. There are only two approved valve options for percutaneous pulmonary valve implantation until now, which are Melody (Medtronic, Minneapolis, Minn, USA) and Sapien (Edwards Lifesciences, Irvine, Ca, USA). Both valves have limitations and do not cover entire patient population. Therefore, the cardiologists need more options to improve outcomes with fewer complications in a such promising area. Herein, we present a case series applying for pulmonary position in conduits and native right ventricular outflow tract of a new transcatheter valve system Myval ® which is designed for transcatheter aortic valve implantation procedures. This is the first patient series in which the use of Myvalv in dysfunctional right ventricular outflow tracts is described, after surgical repair of CHD.

scholarly journals Percutaneous pulmonary valve implantation with the Venus P-valve: clinical experience and early results

2015 ◽  
Vol 26 (4) ◽  
pp. 698-710 ◽  
Author(s):  
Worakan Promphan ◽  
Pimpak Prachasilchai ◽  
Suvipaporn Siripornpitak ◽  
Shakeel A. Qureshi ◽  
Thanarat Layangool
Keyword(s):  
Right Ventricular ◽  
Pulmonary Regurgitation ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Early Results ◽  
Percutaneous Pulmonary Valve Implantation ◽  
The Mean ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve

AbstractBackgroundAt present, the exclusion for percutaneous pulmonary valve implantation for free pulmonary regurgitation after tetralogy of Fallot repair includes an unfavourably large right ventricular outflow tract.ObjectiveTo report feasibility and early experience with a recently developed transcatheter heart valve, Venus P-valveTM, implanted in six patients with severe pulmonary regurgitation with large right ventricular outflow tracts.PatientsThere were two female patients and four male patients. The median age of the patients was 18.5 years, and the mean body weight was 53.8 kg. All the patients were in NYHA class II and had severe pulmonary regurgitation after previous transannular patch repair of tetralogy of Fallot. The median time after the last surgical operation was 13.5 years.ResultsThe Venus P-valveTM was successfully implanted in all the patients with implanted valve diameters ranging from 24 to 32 mm. The mean fluoroscopy time was 29.8 minutes. None of the patients had significant outflow tract gradient or pulmonary regurgitation immediately after valve implantation. Only one patient had unexpected mild proximal valve migration to the right ventricular body during withdrawal of the delivery system. It caused mild paravalvar leak and significant tricuspid regurgitation. At 6 months follow-up, the median of right ventricular end-diastolic volume indices decreased from 146 to 108 ml/m2 (p-value=0.046). The Doppler systolic peak gradient across the valve ranged from 4 to 40 mmHg, and there was no evidence of stent fracture on fluoroscopy or structural valve failure.ConclusionThe Venus P-valveTM can be implanted successfully and effectively in patients with severe pulmonary regurgitation and a large right ventricular outflow tract. The early results with this valve are encouraging.

scholarly journals Favorable Atrial Remodeling After Percutaneous Pulmonary Valve Implantation and Its Association With Changes in Exercise Capacity and Right Ventricular Function

2021 ◽  
Author(s):  
Heiner Latus ◽  
Danik Born ◽  
Nerejda Shehu ◽  
Heiko Stern ◽  
Alfred Hager ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Exercise Capacity ◽  
Left Atrial ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Peak Oxygen Uptake ◽  
Outflow Tract ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve

Background Right atrial (RA) dilatation and impaired right ventricular (RV) filling are common in patients with RV outflow tract dysfunction. We aimed to study potential correlations between atrial function with clinically relevant hemodynamic parameters and to assess the predictive impact of atrial performance on the recovery of exercise capacity and RV pump function after percutaneous pulmonary valve implantation (PPVI). Methods and Results Altogether, 105 patients with right ventricular outflow tract dysfunction (median age at PPVI, 19.2 years; range, 6.2–53.4 years) who underwent cardiac magnetic resonance imaging before and 6 months after PPVI were included. RA and left atrial maximal and minimal volumes as well as atrial passive and active emptying function were assessed from axial cine slices. RA emptying function was inversely related to invasive RV end‐diastolic pressure, and RA passive emptying correlated significantly with peak oxygen uptake. After PPVI, a significant decrease in RA minimum volume was observed, whereas RA passive emptying function improved, and RA active emptying function decreased significantly. Patients with predominant right ventricular outflow tract stenosis showed more favorable changes in RA active and left atrial passive emptying than those with primary volume overload. None of the RA and left atrial emptying parameters was predictive for recovery of peak oxygen uptake or RV ejection fraction. Conclusions In patients with right ventricular outflow tract dysfunction, impaired RA emptying assessed by cardiac magnetic resonance imaging was associated with increased RV filling pressures and lower exercise capacity. PPVI leads to a reduction in RA size and improved passive RA emptying function. However, RA function was not associated with improved exercise performance and RV pump function.

scholarly journals Percutaneous pulmonary valve implantation in patients with right ventricular outflow tract dysfunction: a systematic review and meta-analysis

2019 ◽  
Vol 10 ◽  
pp. 204062231985763 ◽  
Author(s):  
Liyu Ran ◽  
Wuwan Wang ◽  
Francesco Secchi ◽  
Yajie Xiang ◽  
Wenhai Shi ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Regurgitation ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Pulmonary Valve Replacement ◽  
Percutaneous Pulmonary Valve Implantation ◽  
Valve Implantation ◽  
Percutaneous Pulmonary Valve

Background: Pulmonary valve replacement is required for patients with right ventricular outflow tract (RVOT) dysfunction. Surgical and percutaneous pulmonary valve replacement are the treatment options. Percutaneous pulmonary valve implantation (PPVI) provides a less-invasive therapy for patients. The aim of this study was to evaluate the effectiveness and safety of PPVI and the optimal time for implantation. Methods: We searched PubMed, EMBASE, Clinical Trial, and Google Scholar databases covering the period until May 2018. The primary effectiveness endpoint was the mean RVOT gradient; the secondary endpoints were the pulmonary regurgitation fraction, left and right ventricular end-diastolic and systolic volume indexes, and left ventricular ejection fraction. The safety endpoints were the complication rates. Results: A total of 20 studies with 1246 participants enrolled were conducted. The RVOT gradient decreased significantly [weighted mean difference (WMD) = −19.63 mmHg; 95% confidence interval (CI): −21.15, −18.11; p < 0.001]. The right ventricular end-diastolic volume index (RVEDVi) was improved (WMD = −17.59 ml/m²; 95% CI: −20.93, −14.24; p < 0.001), but patients with a preoperative RVEDVi >140 ml/m² did not reach the normal size. Pulmonary regurgitation fraction (PRF) was notably decreased (WMD = −26.27%, 95% CI: −34.29, −18.25; p < 0.001). The procedure success rate was 99% (95% CI: 98–99), with a stent fracture rate of 5% (95% CI: 4–6), the pooled infective endocarditis rate was 2% (95% CI: 1–4), and the incidence of reintervention was 5% (95% CI: 4–6). Conclusions: In patients with RVOT dysfunction, PPVI can relieve right ventricular remodeling, improving hemodynamic and clinical outcomes.

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