Nonsurgical pulmonary valve replacement: Why, when, and how?

Khambadkone, Sachin; Bonhoeffer, Philipp

doi:10.1002/ccd.20122

Cited by 57 publications

(31 citation statements)

References 54 publications

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“…49 Recently, the use of percutaneous valve replacement has received widespread attention. Led by Khambadkone and Bonhoeffer, 52 the procedure has been deployed successfully in RV outflow conduits 53 and has now been extended to include patients with native PS.…”

Section: Percutaneous Balloon Valvuloplasty and Valve Replacementmentioning

confidence: 99%

Adult Congenital Heart Disease

Bashore

2007

Circulation

135

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It has variably been estimated that between 800 000 and 1 million patients with congenital heart disease are now adults and that by 2010 more patients older than 16 years will undergo surgery for congenital heart disease than those younger than 16 years. 1 This review will focus on the clinical aspects of identifying and caring for the portion of the unique population that have right ventricular (RV) outflow tract lesions. Clinical Morphology of the RV Outflow TractThe left ventricle (LV) and RV both have inlet, apical, and outlet portions, although they differ considerably. 2 The inlet of the RV includes the tricuspid valve, and it is separated from the pulmonary valve (PV) by the crista supraventricularis. This structure results in the PV being raised upward. The apical portion of the RV has coarse trabeculations. As shown in Figure 1, the septum is home to a large septomarginal (septal) trabeculation that divides into the anterior and posterior limbs in the outflow tract. A series of septoparietal trabeculations arise along the free wall. The crista supraventricularis inserts between these limbs and is made up of 3 components: the muscular outlet septum, the ventriculoinfundibular fold, and the inner curvature of the RV. 3 The small part that separates the RV and LV cavities is the outlet or conal septum. A loop including the septal trabeculation, the moderator band, septoparietal trabeculations, and the outlet septum can be conceptualized as circling the RV outflow tract. The PV is supported by the circular muscular infundibulum rising outside the RV proper. Abnormalities involving the RV outflow tract involve malpositioning of 1 or more of these structures.

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Section: Percutaneous Balloon Valvuloplasty and Valve Replacementmentioning

confidence: 99%

Adult Congenital Heart Disease

Bashore

2007

Circulation

135

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“…Finally, Khambadkone et al (68) carefully have succeeded with their pulmonary valve replacement; to date, more than 100 patients have been treated, with no mortality and a 98% success rate. The average duration of the implant is 12.3 months.…”

Section: Percutaneous Valve Repair and Replacementmentioning

confidence: 96%

Fourth Annual American College of Cardiology International Lecture

Serruys

2006

Journal of the American College of Cardiology

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“…Cardiac MRI gathers valuable information regarding ventricle mass, function and volumes and is currently the preferred investigation. (7,8,13) …”

Section: Diagnostic Evaluationmentioning

confidence: 99%

“…Major procedural complications included dislodgement of the valve, coronary compression, rupture of homograft and haemothorax due to pulmonary artery perforations. (7,(13)(14)(15)(16)(17)(18) Dislodgement of the device occurred mostly during the initial development phase and could be related to operator inexperience as well as the early learning curve. It is now extremely rare, especially with pre-stenting.…”

Section: Outcomes Of Percutaneous Pulmonary Valve Implantationmentioning

confidence: 99%

Right ventricular outfl ow tract revalvulation using the Melody Valve: The next frontier

Buys

Brown

2017

SAHJ

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Right ventricular outfl ow tract revalvulation using the Melody Valve: The next frontier in terms of years of freedom from re-operation. Freedom from re-operation varies (see Table I) with rates of 97% at one year to, on average, 70% and 31% after 10 and 15 years respectively.(1-3) Low body weight, younger age at insertion, small size grafts and longer cross-clamping times are factors associated with early graft failure.(1,4) It has been estimated that these patients may require up to 5 conduit revisions over a lifetime.Multiple conduit revisions in these patients often result in prolonged hospital stays, increased morbidity and mortality due to the fact that difficulty of surgery increases with every re-operation. This may result in a considerable increase in medical costs and a negative impact on quality of life. Nevertheless, surgery has good long term survival and should be considered as the gold standard of treatment. PERCUTANEOUS RVOT REVALVULATIONUntil recently, surgery was the only option for managing RVOT dysfunction. The first percutaneous pulmonary valve was implanted

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Nonsurgical pulmonary valve replacement: Why, when, and how?

Cited by 57 publications

References 54 publications

Adult Congenital Heart Disease

Adult Congenital Heart Disease

Fourth Annual American College of Cardiology International Lecture

Right ventricular outfl ow tract revalvulation using the Melody Valve: The next frontier

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