Rationale and feasibility of transcatheter pulmonary valve implantation in small conduits with the Edwards Sapien valves
| Autor: | Nikolaus A. Haas, Robert Dalla Pozza, André Jakob, Majed Kanaan, Anja Tengler, Belén Pastor-Villaescusa, Marcus Fischer, S. Ulrich |
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| Rok vydání: | 2021 |
| Předmět: |
Cardiac Catheterization
medicine.medical_specialty Adolescent 030204 cardiovascular system & hematology Prosthesis Design 03 medical and health sciences 0302 clinical medicine Electrical conduit Transcatheter pulmonary valve implantation Humans Medicine 030212 general & internal medicine Covered stent Retrospective Studies Heart Valve Prosthesis Implantation Pulmonary Valve business.industry Pulmonary Valve Insufficiency Surgery Diameter ratio Treatment Outcome Heart Valve Prosthesis Feasibility Studies Cardiology and Cardiovascular Medicine business Edwards sapien |
| Zdroj: | International Journal of Cardiology. 325:45-50 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2020.10.017 |
| Popis: | Conduit dilatation above 110% and TPVI in conduits16 mm is not recommended. However, if we want to reach normal values for RVOT diameters and diminish reintervention rates, pushing these boundaries is essential.Analysis of subsequent patients who underwent TPVI with Edwards Sapien valves in conduits ≤16 mm between 2010 and 2020.In n = 33 cases median age was 13 years (5-20 y) and median weight 47 kg (15-91 kg). Preexisting RVOT grafts were n = 28 Contegra® conduits and n = 5 homografts (12 mm n = 15; 14 mm n = 11; 16 mm n = 7). Implanted were the Sapien (n = 8), Sapien XT (n = 10) and Sapien 3 valve (n = 15) with 20 mm (n = 4), 23 mm (n = 19), 26 mm (n = 9) and 29 mm (n = 1). Mean minimal RVOT diameter after TPVI was 22,7 ± 2,3 mm (18-30 mm) which is 150% of the mean minimal RVOT diameter before TPVI (15,1 ± 4,3 mm). Covered stents were used in n = 10 cases. Contained conduit rupture occurred in n = 7 cases (21%). Residual RVOT gradients of 5,7 ± 4,9 mmHg (0-18 mmHg) showed adequate RV unloading.TPVI could be performed successfully in all patients. Dilatation above 150% and a valve/conduit diameter ratio up to 2,4 were well tolerated. There was a considerable amount of conduit rupture but all were confined without further need for intervention or surgery. |
| Databáze: | OpenAIRE |
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