Extended Application of Percutaneous Pulmonary Valve Implantation

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:53

Article

Momenah, Tarek S.¹  El Oakley, Reida¹  Al Najashi, Khalid¹  Khoshhal, Saad¹  Al Qethamy, Howaida¹  Bonhoeffer, Philipp² 

[1] Prince Sultan Cardiac Ctr, Dept Pediat Cardiol, Riyadh 11159, Saudi Arabia

[2] Great Ormond St Hosp Sick Children, Cardiac Unit, London WC1N 3JH, England

关键词: percutaneous valve;    pulmonary valve;    tetralogy of Fallot;    RVOT patch;   

DOI  :  10.1016/j.jacc.2008.08.061

来源: Elsevier

【 摘 要 】

Objectives This study was designed to report a novel indication for percutaneous pulmonary valve implantation in patients with previous right ventricular outflow tract (RVOT) patch. Background Current indications for percutaneous pulmonary valve implantation are limited to patients who had pulmonary valve stenosis and/or regurgitation in a right ventricle-to-pulmonary artery conduit. Percutaneous pulmonary valve implantation has not been previously reported in patients with severe pulmonary valve regurgitation following repair of tetralogy of Fallot (TOF) using RVOT patch. Methods After assessment of the RVOT patch in multiple projections, a catheter was placed in a distal pulmonary artery branch. In patients with an RVOT patch, sizing of the narrowest diameter of the RVOT patch by manual inflation of a sizing balloon was performed; a stent was placed into the RVOT patch at the level of the narrowest area to anchor the stent and to create an artificial conduit to place the Melody valve. The percutaneous valve was then implanted. Results Seven females and 6 males with a mean age of 14.3 years and mean body weight 45 kg had successful percutaneous implantation of the Melody valve. Four patients had previous repair of TOF using RVOT patch. All patients were discharged within 2 days after the procedure without complications. After a mean of 4 months follow-up all patients were alive and well. Transthoracic echocardiography showed competent pulmonary valve. Chest X-ray showed no stent migration or fracture. Conclusions Percutaneous pulmonary valve implantation can be performed in patients with pulmonary valve regurgitation, including those with previous RVOT patch using pre-stenting techniques, with satisfactory results. (J Am Coll Cardiol 2009; 53: 1859-63) (C) 2009 by the American College of Cardiology Foundation

【 授权许可】

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