Worakan Promphan1, Pimpak Prachasilchai1, Suvipaporn Siripornpitak2, Shakeel A Qureshi3, Thanarat Layangool1. 1. 1Pediatric Heart Center,Queen Sirikit National Institute of Child Health,College of Medicine,Rangsit University,Bangkok,Thailand. 2. 3Department of Paediatric Cardiology,Evelina London Children's Hospital,Guy's and St Thomas' NHS Foundation Trust,London,United Kingdom. 3. 2Department of Radiology, Faculty of Medicine,Ramathibodi Hospital,Mahidol University,Bangkok,Thailand.
Abstract
BACKGROUND: At 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. OBJECTIVE: To 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. Patients There 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. RESULTS: The 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. CONCLUSION: The 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.
BACKGROUND: At 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. OBJECTIVE: To 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. Patients There 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. RESULTS: The 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. CONCLUSION: The 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.
Authors: Matthew A Jolley; Andras Lasso; Hannah H Nam; Patrick V Dinh; Adam B Scanlan; Alex V Nguyen; Anna Ilina; Brian Morray; Andrew C Glatz; Francis X McGowan; Kevin Whitehead; Yoav Dori; Joseph H Gorman; Robert C Gorman; Gabor Fichtinger; Matthew J Gillespie Journal: Catheter Cardiovasc Interv Date: 2018-11-15 Impact factor: 2.692
Authors: Bart W Driesen; Evangeline G Warmerdam; Gert-Jan Sieswerda; Folkert J Meijboom; Mirella M C Molenschot; Pieter A Doevendans; Gregor J Krings; Arie P J van Dijk; Michiel Voskuil Journal: Curr Cardiol Rev Date: 2019