Zachary A Spigel1, Iki Adachi2, Ziyad M Binsalamah2, Dhaval Parekh3, Athar M Qureshi3. 1. Department of Surgery, Allegheny Health Network, Pittsburgh, PA, USA. 2. Department of Surgery, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA. 3. The Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Abstract
BACKGROUND: Transcatheter pulmonary valve replacement (TPVR) is now an established modality for pulmonary valve replacement in suitable candidates. We aim to describe our experience with TPVR in adults. METHODS: This is a descriptive study of all TPVR performed in adults with congenital heart disease at a single institution from 2010-2020. All adult patients (defined as 18 years old or older at TPVR) were included. Time-to-event outcomes were described using Kaplan-Meier estimates with 95% confidence intervals (CIs). RESULTS: Out of a total of 200 patients that had undergone TPVR, 81 patients (57% male) met the inclusion criteria, with a median age and weight of 26 years (IQR 21-37) and 71.0 kg (IQR 54.6-89.0), respectively. In the cohort, 45 (56%) patients had tetralogy of Fallot. While 53 (65%) patients received a Melody valve, a Sapien valve (S3 in 20, XT in eight) was implanted in the rest. Pre-stenting was performed in 49 (52%) patients. One patient died of severe heart failure a year following TPVR. One patient had a second TPVR performed 2.2 years following initial TPVR for severe pulmonary regurgitation. Valve survival at 2.2 years was 94% (95% CI: 87-100%). Four patients developed endocarditis. Endocarditis-free survival was 89% (95% CI: 80-100%) at three years. CONCLUSIONS: Our experience suggests favorable results of TPVR in adults with congenital heart disease. Additional research would be warranted with a focus on total valve longevity and patient reported outcomes, in order to improve the understanding of TPVR in this population and further refine this technology. 2021 Annals of Cardiothoracic Surgery. All rights reserved.
BACKGROUND: Transcatheter pulmonary valve replacement (TPVR) is now an established modality for pulmonary valve replacement in suitable candidates. We aim to describe our experience with TPVR in adults. METHODS: This is a descriptive study of all TPVR performed in adults with congenital heart disease at a single institution from 2010-2020. All adult patients (defined as 18 years old or older at TPVR) were included. Time-to-event outcomes were described using Kaplan-Meier estimates with 95% confidence intervals (CIs). RESULTS: Out of a total of 200 patients that had undergone TPVR, 81 patients (57% male) met the inclusion criteria, with a median age and weight of 26 years (IQR 21-37) and 71.0 kg (IQR 54.6-89.0), respectively. In the cohort, 45 (56%) patients had tetralogy of Fallot. While 53 (65%) patients received a Melody valve, a Sapien valve (S3 in 20, XT in eight) was implanted in the rest. Pre-stenting was performed in 49 (52%) patients. One patient died of severe heart failure a year following TPVR. One patient had a second TPVR performed 2.2 years following initial TPVR for severe pulmonary regurgitation. Valve survival at 2.2 years was 94% (95% CI: 87-100%). Four patients developed endocarditis. Endocarditis-free survival was 89% (95% CI: 80-100%) at three years. CONCLUSIONS: Our experience suggests favorable results of TPVR in adults with congenital heart disease. Additional research would be warranted with a focus on total valve longevity and patient reported outcomes, in order to improve the understanding of TPVR in this population and further refine this technology. 2021 Annals of Cardiothoracic Surgery. All rights reserved.
Authors: Zachary A Spigel; Huirong Zhu; Athar M Qureshi; Daniel J Penny; Christopher A Caldarone; Jeffrey S Heinle; Ziyad M Binsalamah Journal: Semin Thorac Cardiovasc Surg Date: 2020-06-04
Authors: Doff B McElhinney; Lars Sondergaard; Aimee K Armstrong; Lisa Bergersen; Robert F Padera; David T Balzer; Te-Hsin Lung; Felix Berger; Evan M Zahn; Robert G Gray; William E Hellenbrand; Jacqueline Kreutzer; Andreas Eicken; Thomas K Jones; Peter Ewert Journal: J Am Coll Cardiol Date: 2018-12-04 Impact factor: 24.094
Authors: John P Cheatham; William E Hellenbrand; Evan M Zahn; Thomas K Jones; Darren P Berman; Julie A Vincent; Doff B McElhinney Journal: Circulation Date: 2015-05-05 Impact factor: 29.690
Authors: William M Wilson; Lee N Benson; Mark D Osten; Ashish Shah; Eric M Horlick Journal: JACC Cardiovasc Interv Date: 2015-12-21 Impact factor: 11.195
Authors: Alexander C Egbe; Heidi M Connolly; William R Miranda; Joseph A Dearani; Hartzell V Schaff Journal: Ann Thorac Surg Date: 2019-07-16 Impact factor: 4.330
Authors: Aimee K Armstrong; Felix Berger; Thomas K Jones; John W Moore; Lee N Benson; John P Cheatham; Daniel R Turner; John F Rhodes; Julie A Vincent; Thomas Zellers; Te-Hsin Lung; Andreas Eicken; Doff B McElhinney Journal: Catheter Cardiovasc Interv Date: 2019-08-16 Impact factor: 2.692
Authors: Shabana Shahanavaz; Evan M Zahn; Daniel S Levi; Jamil A Aboulhousn; Sebastien Hascoet; Athar M Qureshi; Diego Porras; Gareth J Morgan; Holly Bauser Heaton; Mary Hunt Martin; Britton Keeshan; Jeremy D Asnes; Damien Kenny; Jeremy M Ringewald; Jenny E Zablah; Margaret Ivy; Brian H Morray; Alejandro J Torres; Darren P Berman; Matthew J Gillespie; Kasey Chaszczewski; Jeffrey D Zampi; Kevin P Walsh; Plessis Julien; Bryan H Goldstein; Shyam K Sathanandam; Clement Karsenty; David T Balzer; Doff B McElhinney Journal: J Am Coll Cardiol Date: 2020-12-15 Impact factor: 24.094
Authors: Christopher R Broda; Venkatachalam Mulukutla; Manish Bansal; Daniel J Penny; Charles E Mullins; Athar M Qureshi Journal: World J Pediatr Congenit Heart Surg Date: 2020-05
Authors: Shabana Shahanavaz; Jeremy D Asnes; Jochen Grohmann; Athar M Qureshi; Jonathan J Rome; Daniel Tanase; Matthew A Crystal; Larry A Latson; Brian H Morray; William Hellenbrand; David T Balzer; Marc Gewillig; Jon C Love; Farhouch Berdjis; Matthew J Gillespie; Doff B McElhinney Journal: Circ Cardiovasc Interv Date: 2018-08 Impact factor: 6.546
Authors: Doff B McElhinney; Yulin Zhang; Jamil A Aboulhosn; Brian H Morray; Elżbieta Katarzyna Biernacka; Athar M Qureshi; Alejandro J Torres; Shabana Shahanavaz; Bryan H Goldstein; Allison K Cabalka; Holly Bauser-Heaton; Stanimir Georgiev; Felix Berger; Oscar Millan-Iturbe; Lynn F Peng; Aimee K Armstrong; Daniel S Levi; Aneta Fronczak-Jakubczyk; Lars Sondergaard; Jason H Anderson; Dietmar Schranz; Thomas K Jones; John P Cheatham; Stephan Schubert; Peter Ewert Journal: J Am Coll Cardiol Date: 2021-08-10 Impact factor: 24.094