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The Journal of Thoracic and... Oct 2022
Topics: Cardiac Surgical Procedures; Heart Valve Prosthesis Implantation; Humans; Pulmonary Valve; Pulmonary Valve Insufficiency; Tetralogy of Fallot; Treatment Outcome
PubMed: 35337677
DOI: 10.1016/j.jtcvs.2022.02.043 -
Current Cardiology Reviews 2019Patients with congenital heart disease (CHD) with right ventricle outflow tract (RVOT) dysfunction need sequential pulmonary valve replacements throughout their life in... (Review)
Review
Patients with congenital heart disease (CHD) with right ventricle outflow tract (RVOT) dysfunction need sequential pulmonary valve replacements throughout their life in the majority of cases. Since their introduction in 2000, the number of percutaneous pulmonary valve implantations (PPVI) has grown and reached over 10,000 procedures worldwide. Overall, PPVI has been proven safe and effective, but some anatomical variations can limit procedural success. This review discusses the current status and future perspectives of the procedure.
Topics: Female; Heart Valve Prosthesis Implantation; Humans; Male; Pulmonary Valve; Treatment Outcome
PubMed: 30582483
DOI: 10.2174/1573403X15666181224113855 -
Expert Review of Medical Devices Jun 2020Right ventricular outflow tract (RVOT) dysfunction is common among individuals with congenital heart disease (CHD). Surgical intervention often carries prohibitive risks... (Review)
Review
INTRODUCTION
Right ventricular outflow tract (RVOT) dysfunction is common among individuals with congenital heart disease (CHD). Surgical intervention often carries prohibitive risks due to the need for sequential pulmonary valve (PV) replacements throughout their life in the majority of cases. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with RVOT dysfunction.
AREAS COVERED
In this review, we examine the pathophysiology of RVOT dysfunction, indications for tPVR, and the procedural aspect. Advancements in clinical application and valve technology will also be covered.
EXPERT OPINION
tPVR is widely accepted as an alternative to surgery to address RVOT dysfunction, but still significant numbers of patients with complex RVOT morphology deemed not suitable for tPVR. As the technology continues to evolve, new percutaneous valves will allow such complex RVOT patient to benefit from tPVR.
Topics: Cardiac Catheterization; Child; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Patient Selection; Pulmonary Valve; Treatment Outcome
PubMed: 32459512
DOI: 10.1080/17434440.2020.1775578 -
Cardiology in the Young Dec 2014Diseases of the tricuspid and pulmonary valve are common in childhood. These include congenital anomalies, acquired lesions, and secondary valve compromise due to left... (Review)
Review
Diseases of the tricuspid and pulmonary valve are common in childhood. These include congenital anomalies, acquired lesions, and secondary valve compromise due to left heart disease. A comprehensive and methodical approach to the echocardiographic assessment of these diseases of the tricuspid and pulmonary valve is necessary for best care of children with these conditions.
Topics: Child; Echocardiography; Heart Valve Diseases; Humans; Pulmonary Valve; Tricuspid Valve
PubMed: 25647376
DOI: 10.1017/S1047951114002194 -
Cardiovascular Revascularization... Nov 2021The objective of this study is to describe the recent trends and in-hospital outcomes with percutaneous pulmonic valve implantation (PPVI) and surgical pulmonic valve...
BACKGROUND
The objective of this study is to describe the recent trends and in-hospital outcomes with percutaneous pulmonic valve implantation (PPVI) and surgical pulmonic valve replacement (SPVR) in adult hospitals in the US after the availability of both the Melody valve (Medtronic Inc., Minneapolis, Minnesota) and the Sapien XT valve (Edwards Lifesciences, Irvine, CA).
METHODS
We queried the National Inpatient Sample database (NIS) from January 2016 to December 2017 to identify hospitalizations for PPVI and SPVR.
RESULTS
We identified 5455 weighted discharges with PPVI and SPVR (PPVI=1140, SPVR=4305). PPVI procedures had increased in number over 2016 and 2017 (115 procedure at the first quarter of 2016, 195 procedures in the final quarter of 2017, P-trend=0.086), while SPVR volume remained constant. The incidence of in-hospital mortality was low with both procedures (SPRV: 1.6% vs. PPVI: 0.9%, p=0.071). SPVR had worse in-hospital outcomes, was associated with a longer length of stay [5 days vs. 1 day, p<0.001], and comparable cost of index hospitalization [$51,657 vs. $51,193] compared with PPVI.
CONCLUSION
After approval of the Sapien valve for commercial use in 2016, PPVI procedures have increased in frequency. PPVI is associated with lower procedural complications than SPVR, however, both carry a low risk of mortality. Despite the higher cost of the valves and delivery systems, PPVI is associated with a slightly lower cost of index hospitalization compared with SPVR, likely due to the higher in-hospital complications and LOS of the latter.
Topics: Adult; Cardiac Catheterization; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Pulmonary Valve; Treatment Outcome
PubMed: 33422413
DOI: 10.1016/j.carrev.2020.12.035 -
Seminars in Thoracic and Cardiovascular... 2022
Topics: Aortic Valve Stenosis; Heart Valve Prosthesis Implantation; Humans; Pulmonary Valve; Transcatheter Aortic Valve Replacement; Treatment Outcome
PubMed: 35257908
DOI: 10.1053/j.semtcvs.2022.02.008 -
Pacing and Clinical Electrophysiology :... Jul 2021Ventricular tachycardia and premature ventricular complexes (PVCs) arising from right ventricular outflow tract (RVOT) are the most common type of ventricular... (Review)
Review
Ventricular tachycardia and premature ventricular complexes (PVCs) arising from right ventricular outflow tract (RVOT) are the most common type of ventricular arrhythmias (VAs) in patients without structural heart disease. Radiofrequency ablation is now the gold standard of treatment in this setting due to high efficacy rates and optimal safety profile. During the last few years, the pulmonary valve (PV) and the pulmonary artery (PA) have attracted much attention as reliable sites of origin of RVOT-type arrhythmias. In the mean while intracardiac echocardiogram (ICE) has undoubtedly improved our understanding of the cardiac anatomy. Aim of this paper is to provide an illustrated step-by-step guide on how to use ICE with the CARTOSOUND module to visualize and reconstruct 3D shell of the RV, the PV, as well of other contiguous anatomical structures (i.e., the aortic valve and coronary arteries) to perform aware and safe ablation in this region.
Topics: Cardiac Surgical Procedures; Echocardiography; Humans; Imaging, Three-Dimensional; Pulmonary Valve; Surgery, Computer-Assisted
PubMed: 33786840
DOI: 10.1111/pace.14233 -
Archives of Gynecology and Obstetrics Nov 2022The purpose of this study was to explore the outcome in fetuses with prenatal diagnosis of absent pulmonary valve syndrome (APVS) on ultrasound imaging.
OBJECTIVE
The purpose of this study was to explore the outcome in fetuses with prenatal diagnosis of absent pulmonary valve syndrome (APVS) on ultrasound imaging.
METHODS
A manual web scraping technique was utilized, where MEDLINE and EMBASE were searched along the combination with other relevant medical subject headings such as "absent pulmonary valve syndrome", "prenatal APVS" and "APVS/outcome". The observed outcomes encompassed the rate of chromosomal abnormalities, associations and malformations linked to APVS and fetuses with APVS. A quality assessment of the included studies was also performed. We used meta-analyses of proportions to combine data and fixed or random-effects models according to the heterogeneity of the results.
RESULTS
Seven studies including 199 fetuses with APVS were included in the analysis. The median gestational age at referral to the tertiary center was 24.8 weeks. An association to tetralogy of Fallot (TOF) could be seen in 84.4% of all cases. In total 140 out of 199 cases underwent invasive testing, with a total number of 55 abnormal karyotypes [39.3% (95% CI 31.1-47.9%)]. 35.2% of the patients opted for termination of pregnancy (95% CI 28.5-42.3%).
CONCLUSION
The analysis underlines the distribution of fetuses with APVS, with 84.4% of cases presenting with TOF/APVS and only 12.6% having APVS/intact ventricular septum (IVS). Larger and more prospective study analyses is now needed, especially focusing on long-term follow-up periods of fetuses and children with APVS. Particularly as the postnatal course shows great variety depending on prenatal diagnosis.
Topics: Child; Female; Humans; Infant; Pregnancy; Prospective Studies; Pulmonary Atresia; Pulmonary Valve; Retrospective Studies; Tetralogy of Fallot; Ultrasonography, Prenatal
PubMed: 35043273
DOI: 10.1007/s00404-022-06397-4 -
Heart, Lung & Circulation Jan 2022Minimally invasive cardiac surgery is mainly dedicated to acquired left-sided valve diseases. Ministernotomy is widely used for aortic valve repair or replacement,...
Minimally invasive cardiac surgery is mainly dedicated to acquired left-sided valve diseases. Ministernotomy is widely used for aortic valve repair or replacement, whereas pulmonary valve repair via this approach has been reported only recently. This article aims to describe the use of ministernotomy for pulmonary valve replacement in adult congenital patients.
Topics: Adult; Cardiac Surgical Procedures; Heart Valve Prosthesis Implantation; Humans; Minimally Invasive Surgical Procedures; Pulmonary Valve; Treatment Outcome
PubMed: 34600813
DOI: 10.1016/j.hlc.2021.09.003 -
Seminars in Thoracic and Cardiovascular... 2023
Topics: Humans; Pulmonary Valve; Treatment Outcome; Cardiac Surgical Procedures; Tetralogy of Fallot; Heart Valve Prosthesis Implantation; Pulmonary Valve Insufficiency
PubMed: 36599796
DOI: 10.1053/j.semtcvs.2022.11.009