Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction

Bonhoeffer, Philipp; Boudjemline, Younès; Saliba, Zakhia; Merckx, Jacques; Aggoun, Yacine; Bonnet, Damien; Acar, Philippe; Bidois, J. Le; Sidi, Daniel; Kachaner, J

doi:10.1016/s0140-6736(00)02844-0

Cited by 953 publications

(498 citation statements)

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“…Transcatheter pulmonary valve (TPV) placement is a recent development that has been reported to provide a safe and effective nonsurgical alternative for the treatment of RVOT dysfunction in this patient population. [3][4][5] As TPV therapy becomes more widely adopted, it is important to assess the clinical and physiologic consequences of the procedure objectively and quantitatively. The hemodynamic benefits of TPV implantation have been previously reported.…”

Section: Resultsmentioning

confidence: 99%

Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial

Batra

McElhinney

Wang

et al. 2012

American Heart Journal

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Section: Resultsmentioning

confidence: 99%

Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial

Batra

McElhinney

Wang

et al. 2012

American Heart Journal

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“…These devices, which were originally designed to restore blood flow in obstructed vessels, have now been used as scaffolding structures for biological valves, thus opening up the possibility of treating valve disease with percutaneous, minimally invasive techniques rather than open-heart surgery. The first percutaneous heart valve was implanted in humans in 2000-percutaneous pulmonary valve implantation (PPVI) into a dysfunctional right ventricle (RV) to pulmonary artery conduit (Bonhoeffer et al 2000). The device consists of a bovine jugular venous valve sutured into a balloonexpandable stent (Melody: Medtronic Inc., Minneapolis, MN, USA).…”

Section: Introductionmentioning

confidence: 99%

Patient-specific reconstructed anatomies and computer simulations are fundamental for selecting medical device treatment: application to a new percutaneous pulmonary valve

Capelli

Migliavacca

Bonhoeffer³

et al. 2010

Phil. Trans. R. Soc. A.

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Nowadays, percutaneous pulmonary valve implantation is a successful alternative to surgery for patients requiring treatment of pulmonary valve dysfunction. However, owing to the wide variety of implantation site morphology, size and dynamics, only about 15 per cent of cases are suitable for current devices. In order to increase the number of patients who could benefit from minimally invasive procedures, a new valved stent graft for percutaneous implantation has been designed recently. In this study, patient-specific computational analyses have been applied to investigate the suitability of new device designs, using real data from 62 patients who had undergone surgical pulmonary valve replacement. Magnetic resonance images of these patients before surgery were elaborated using imaging post-processing software to reconstruct the three-dimensional volume of each patient's implantation site. Three stent designs were created and tested in these patient outflow tracts using finite-element simulations: stent graft SG1 resembles the first device tested in animals; stent graft SG2 is a custom device tailored for a specific patient morphology; and stent graft SG3 represents a hypothetical larger device. The three devices showed an implantation success rate of 37 per cent, 42 per cent and 63 per cent, respectively. Using patientspecific simulations, we have shown that a percutaneous approach with these new devices may be possible for many patients who are currently referred for surgery. Furthermore, when the new devices become available, the methodologies described may help clinicians in the decision-making process, by enabling virtual implantation prior to the actual procedure.

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“…One decade after Bonhoeffer et al1 demonstrated the feasibility of transcatheter pulmonary valve implantation (TPVI) in a right ventricular outflow tract (RVOT) conduit, the US Food and Drug Administration approved the Melody valve (a modified version of the original device of Bonhoeffer et al, 1 manufactured by Medtronic Inc, Minneapolis, MN)2 in 2010.…”

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Infective Endocarditis After Melody Valve Implantation in the Pulmonary Position: A Systematic Review

Abdelghani

Nassif

Blom

et al. 2018

JAHA

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BackgroundInfective endocarditis (IE) after transcatheter pulmonary valve implantation (TPVI) in dysfunctioning right ventricular outflow tract conduits has evoked growing concerns. We aimed to investigate the incidence and the natural history of IE after TPVI with the Melody valve through a systematic review of published data.Methods and ResultsPubMed, EMBASE, and Web of Science databases were systematically searched for articles published until March 2017, reporting on IE after TPVI with the Melody valve. Nine studies (including 851 patients and 2060 patient‐years of follow‐up) were included in the analysis of the incidence of IE. The cumulative incidence of IE ranged from 3.2% to 25.0%, whereas the annualized incidence rate ranged from 1.3% to 9.1% per patient‐year. The median (interquartile range) time from TPVI to the onset of IE was 18.0 (9.0–30.4) months (range, 1.0–72.0 months). The most common findings were positive blood culture (93%), fever (89%), and new, significant, and/or progressive right ventricular outflow tract obstruction (79%); vegetations were detectable on echocardiography in only 34% of cases. Of 69 patients with IE after TPVI, 6 (8.7%) died and 35 (52%) underwent surgical and/or transcatheter reintervention. Death or reintervention was more common in patients with new/significant right ventricular outflow tract obstruction (69% versus 33%; P=0.042) and in patients with non‐streptococcal IE (73% versus 30%; P=0.001).ConclusionsThe incidence of IE after implantation of a Melody valve is significant, at least over the first 3 years after TPVI, and varies considerably between the studies. Although surgical/percutaneous reintervention is a common consequence, some patients can be managed medically, especially those with streptococcal infection and no right ventricular outflow tract obstruction.

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Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction

Cited by 953 publications

References 15 publications

Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial

Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial

Patient-specific reconstructed anatomies and computer simulations are fundamental for selecting medical device treatment: application to a new percutaneous pulmonary valve

Infective Endocarditis After Melody Valve Implantation in the Pulmonary Position: A Systematic Review

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