Skip to main content

Advertisement

SpringerLink
Log in

Balloon-Expandable Pulmonary Valves for Patched or Native Right Ventricular Outflow Tracts

  • Research
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

The implantation of percutaneous balloon expandable valves in native or patched right ventricular outflow tracts (nRVOT) is a challenging technique due to the diversity of anatomies and shapes, the large sizes, and the distensibility of the nRVOT, for which specific techniques have been developed. We present a single center experience with balloon expandable percutaneous pulmonary valves in nRVOT, describing the techniques used, complications observed, and a short-mid term follow-up.. This is a single center descriptive study of patients who underwent a percutaneous pulmonary valve implantation in a nRVOT with a balloon expandable pulmonary valve in our center between September 2012 and June 2022.. We implanted successfully 45 valves in 46 patients (20 Sapien and 25 Melody). Tetralogy of Fallot or pulmonary atresia with VSD were the main congenital heart disease (n = 32). All were pre-stented, 18 in a one step procedure. We used a Dryseal sheath in 13/21 Sapien. In 6 patients we used the anchoring technique, 5 with a very large nRVOT and one pyramidal nRVOT. In the 3.5 year follow-up 7 patients developed endocarditis and 3 required a valve redilation, no fractures were observed. PPVI of native RVOT with balloon expandable valves is feasible in a number of selected anatomies, including large or pyramidal nRVOT, using specific techniques, (presenting, LPA anchoring).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Abbreviations

RVOT:

Right ventricular outflow tract

nRVOT:

Native or patched right ventricular outflow tract

PPVI:

Percutaneous pulmonary valve implantation

LPA:

Left pulmonary artery

RPA:

Right pulmonary artery

CHD:

Congenital heart disease

TOF:

Tetralogy of Fallot

PA:

Pulmonary atresia

VSD:

Ventricular septal defect

PS:

Pulmonary stenosis

DORV:

Double-outlet right ventricle

TGA:

Transposition of the great arteries

References

  1. Bonhoeffer P, Boudjemline Y, Saliba Z, Merckx J, Aggoun Y, Bonnet D, Acar P, Le Bidois J, Sidi D, Kachaner J (2000) Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet. https://doi.org/10.1016/S0140-6736(00)02844-0]

    Article  PubMed  Google Scholar 

  2. Boone RH, Webb JG, Horlick E, Benson L, Cao QL, Nadeem N, Kiess M, Hijazi ZM (2010) Transcatheter pulmonary valve implantation using the Edwards SAPIEN transcatheter heart valve. Catheter CardiovascInterv 75:286–294. https://doi.org/10.1002/ccd.22250]

    Article  Google Scholar 

  3. Esmaeili A, Khalil M, Behnke-Hall K, Gonzalez YGonzalez MB, Kerst G, Fichtlscherer S, Akintuerk H, Schranz D (2019) Percutaneous pulmonary valve implantation (PPVI) in non-obstructive right ventricular outflow tract: limitations and mid-term outcomes. Transl Pediatr. 8(2):107–113. https://doi.org/10.21037/tp.2019.04.02

    Article  PubMed  PubMed Central  Google Scholar 

  4. Martin MH, Meadows J, McElhinney DB, Goldstein BH, Bergersen L, Qureshi AM, Shahanavaz S, Aboulhosn J, Berman D, Peng L, Gillespie M, Armstrong A, Weng C, Minich LL, Gray RG (2018) Safety and feasibility of melody transcatheter pulmonary valve replacement in the native right ventricular outflow tract: a multicenter pediatric heart network scholar study. JACC Cardiovasc Interv 11(16):1642–1650. https://doi.org/10.1016/j.jcin.2018.05.051. (Epub 2018 Aug 1 PMID: 30077685)

    Article  PubMed  Google Scholar 

  5. Alvarez-Fuente M, Garrido-Lestache E, Fernandez-Pineda L, Romera B, Sánchez I, Centella T, Abelleira C, Villagrá S, Tamariz R, Barrios E, Lamas MJ, Gomez R, Del Cerro MJ (2016) Timing of pulmonary valve replacement: how much can the right ventricle dilate before it looses its remodeling potential? Pediatr Cardiol 37(3):601–605. https://doi.org/10.1007/s00246-015-1320-4. (Epub 2015 Dec 21 PMID: 26687177)

    Article  CAS  PubMed  Google Scholar 

  6. Baumgartner H, De Backer J, Babu-Narayan SV, Budts W, Chessa M, Diller GP, Lung B, Kluin J, Lang IM, Meijboom F, Moons P, Mulder BJM, Oechslin E, Roos-Hesselink JW, Schwerzmann M, Sondergaard L, Zeppenfeld K, ESC Scientific Document Group (2021) ESC Guidelines for the management of adult congenital heart disease. Eur Heart J 42(6):563–645. https://doi.org/10.1093/eurheartj/ehaa554. (PMID: 32860028)

    Article  CAS  PubMed  Google Scholar 

  7. Malekzadeh-Milani S, ladoucer M, Cohen S, Iserin L, Boudjemline Y (2014) Results of transcatheter pulmonary valvulation in native or patched right ventricular outflow tracts. Arch Cardiovasc Dis 07:592–8

    Article  Google Scholar 

  8. Karsenty C, Malekzadeh-Milani S, Fraisse A, Gewillig M, Bonnet D, Aldebert P, Ovaert C, Bouvaist H, Kempny A, Houeijeh A, Petit J, Hascoet S (2020) Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation. Arch Cardiovasc Dis 113(2):113–120. https://doi.org/10.1016/j.acvd.2019.12.004. (Epub 2020 Feb 18 PMID: 32081640)

    Article  PubMed  Google Scholar 

  9. Georgiev S, Tanase D, Ewert P, Meierhofer C, Hager A, von Ohain JP, Eicken A (2018) Percutaneous pulmonary valve implantation in patients with dysfunction of a “native” right ventricular outflow tract—Mid-term results. Int J Cardiol 1(258):31–35. https://doi.org/10.1016/j.ijcard.2017.11.091. (PMID: 29544952)

    Article  Google Scholar 

  10. Kenny D, Morgan GJ, Murphy M, AlAlwi K, Giugno L, Zablah J, Carminati M, Walsh K (2019) Use of 65 cm large caliber Dryseal sheaths to facilitate delivery of the Edwards SAPIEN valve to dysfunctional right ventricular outflow tracts. Catheter Cardiovasc Interv 94(3):409–413. https://doi.org/10.1002/ccd.28409. (Epub 2019 Aug 13 PMID: 31408262)

    Article  PubMed  Google Scholar 

  11. Couture EL, Labbé BM, DeLarochellière R, Rodés-Cabau J, Paradis J-M (2016) Stuck leaflet after transcatheter aortic valve replacement with a SAPIEN-3 Valve: new valve, old complication. JACC Cardiovasc Interv 9:e133–e135

    Article  PubMed  Google Scholar 

  12. Güzeltaş A, Tanıdır IC, Gökalp S, Topkarcı MA, Şahin M, Ergül Y (2021) Implantation of the Edwards SAPIEN XT and SAPIEN 3 valves for pulmonary position in enlarged native right ventricular outflow tract. Anatol J Cardiol 25(2):96–103. https://doi.org/10.14744/AnatolJCardiol.2020.46024.PMID:33583816;PMCID:PMC8114652

    Article  PubMed  PubMed Central  Google Scholar 

  13. Giugno L, Faccini A, Carminati M (2020) Percutaneous pulmonary valve implantation. Korean Circ J 50(4):302–316. https://doi.org/10.4070/kcj.2019.0291.PMID:32157831;PMCID:PMC7067602

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ansari MM, Cardoso R, Garcia D, Sandhu S, Horlick E, Brinster D, Martucci G, Piazza N (2015) Percutaneous pulmonary valve implantation: present status and evolving future. J Am Coll Cardiol 66(20):2246–2255. https://doi.org/10.1016/j.jacc.2015.09.055. (PMID: 26564602)

    Article  PubMed  Google Scholar 

  15. Morgan GJ, Sadeghi S, Salem MM, Wilson N, Kay J, Roth-man A et al (2019) SAPIEN valve for percutaneous transcatheterpulmonary valve replacement without ‘“pre-stenting”’: amulti-institutional experience. Catheter Cardiovasc Interv 93:324–329

    Article  PubMed  Google Scholar 

  16. Sinha S, Aboulhosn J, Asnes J, Bocks M, Zahn E, Goldstein BH et al (2019) Initial results from the off-label use of the SAPIEN S3 valve for percutaneous transcatheter pulmonary valve replacement: a multi-institutional experience. Catheter Cardiovasc Interv 93(455–63):29

    Google Scholar 

  17. Cardoso R, Ansar M, Garcia D et al (2016) Prestenting for prevention of melody valve fractures: a systematic review and meta-analysis. Catheter Cardiovasc Interv. 87(3):534–539

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiology and Adult Congenital Heart Disease, Ramón y Cajal Hospital, Madrid, Spain

    M. Álvarez-Fuente, M. Toledano, E. Garrido-Lestache, I. Sánchez, I. Molina, N. Rivero, I. García-Ormazábal & M. J. del Cerro

Authors
  1. M. Álvarez-Fuente
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Toledano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Garrido-Lestache
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I. Molina
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. Rivero
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. I. García-Ormazábal
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. J. del Cerro
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MAF and MJC wrote the main manuscript and prepared the figures. All authors collected the data and reviewed the manuscript.

Corresponding author

Correspondence to M. Álvarez-Fuente.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Álvarez-Fuente, M., Toledano, M., Garrido-Lestache, E. et al. Balloon-Expandable Pulmonary Valves for Patched or Native Right Ventricular Outflow Tracts. Pediatr Cardiol 44, 1285–1292 (2023). https://doi.org/10.1007/s00246-023-03173-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-023-03173-2

Keywords

Search

Navigation