FOCUS ISSUE: VALVULAR HEART DISEASE: CLINICAL RESEARCH
Extended Application of Percutaneous Pulmonary Valve Implantation
Tarek S. Momenah, MD*,*,
Reida El Oakley, MD*,
Khalid Al Najashi, MD*,
Saad Khoshhal, MD*,
Howaida Al Qethamy, MD* and
Philipp Bonhoeffer, MD
* Department of Pediatric Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
Cardiac Unit, Great Ormond Street Hospital for Children, London, United Kingdom
Manuscript received June 18, 2008;
accepted August 13, 2008.
* Reprint requests and correspondence: Dr. Tarek S. Momenah, Prince Sultan Cardiac Center, P.O. Box 7897, Riyadh 11159, Saudi Arabia (Email: kidecho{at}yahoo.com).
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.
Key Words: percutaneous valve • pulmonary valve • tetralogy of Fallot • RVOT patch
|
Abbreviations and Acronyms
| | PA = pulmonary artery | | PPVI = percutaneous pulmonary valve implantation | | PVR = pulmonary valve regurgitation | | RV = right ventricular | | RVOT = right ventricular outflow tract | | TOF = tetralogy of Fallot |
|
Related Article
-
Inside This Issue
J. Am. Coll. Cardiol. 2009 53: A28.
[Full Text]
[PDF]
This article has been cited by other articles:
|
|
|
|
 
B. Weber, J. Scherman, M. Y. Emmert, J. Gruenenfelder, R. Verbeek, M. Bracher, M. Black, J. Kortsmit, T. Franz, R. Schoenauer, et al.
Injectable living marrow stromal cell-based autologous tissue engineered heart valves: first experiences with a one-step intervention in primates
Eur. Heart J.,
November 2, 2011;
32(22):
2830 - 2840.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. von Wattenwyl, R. Arnold, M. Siepe, F. Beyersdorf, and C. Schlensak
Implantation of a catheter-based self-expanding pulmonary valve in congenital heart surgery: results of a pilot study
Eur J Cardiothorac Surg,
September 1, 2011;
40(3):
552 - 556.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. F. Feltes, E. Bacha, R. H. Beekman III, J. P. Cheatham, J. A. Feinstein, A. S. Gomes, Z. M. Hijazi, F. F. Ing, M. de Moor, W. R. Morrow, et al.
Indications for Cardiac Catheterization and Intervention in Pediatric Cardiac Disease: A Scientific Statement From the American Heart Association
Circulation,
June 7, 2011;
123(22):
2607 - 2652.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Eicken, P. Ewert, A. Hager, B. Peters, S. Fratz, T. Kuehne, R. Busch, J. Hess, and F. Berger
Percutaneous pulmonary valve implantation: two-centre experience with more than 100 patients
Eur. Heart J.,
May 2, 2011;
32(10):
1260 - 1265.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. D. Robb, M. A. Harris, M. Minakawa, E. Rodriguez, K. J. Koomalsingh, T. Shuto, D. C. Shin, Y. Dori, A. C. Glatz, J. J. Rome, et al.
Melody Valve Implantation Into the Branch Pulmonary Arteries for Treatment of Pulmonary Insufficiency in an Ovine Model of Right Ventricular Outflow Tract Dysfunction Following Tetralogy of Fallot Repair
Circ Cardiovasc Interv,
February 1, 2011;
4(1):
80 - 87.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Nordmeyer, P. Lurz, S. Khambadkone, S. Schievano, A. Jones, D. B. McElhinney, A. M. Taylor, and P. Bonhoeffer
Pre-stenting with a bare metal stent before percutaneous pulmonary valve implantation: acute and 1-year outcomes
Heart,
January 15, 2011;
97(2):
118 - 123.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Yedidya, G. Y. Stein, M. Vaturi, L. Blieden, H. Bernstine, S. D. Pitlik, and S. Fuchs
Positron Emission Tomography/Computed Tomography for the Diagnosis of Endocarditis in Patients With Pulmonic Stented Valve/Pulmonic Stent
Ann. Thorac. Surg.,
January 1, 2011;
91(1):
287 - 289.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. B. McElhinney, W. E. Hellenbrand, E. M. Zahn, T. K. Jones, J. P. Cheatham, J. E. Lock, and J. A. Vincent
Short- and Medium-Term Outcomes After Transcatheter Pulmonary Valve Placement in the Expanded Multicenter US Melody Valve Trial
Circulation,
August 3, 2010;
122(5):
507 - 516.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Capelli, A. M. Taylor, F. Migliavacca, P. Bonhoeffer, and S. Schievano
Patient-specific reconstructed anatomies and computer simulations are fundamental for selecting medical device treatment: application to a new percutaneous pulmonary valve
Phil Trans R Soc A,
June 28, 2010;
368(1921):
3027 - 3038.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. H. Rahimtoola
The Year in Valvular Heart Disease
J. Am. Coll. Cardiol.,
April 20, 2010;
55(16):
1729 - 1742.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, G. K. Feld, B. H. Greenberg, J. Hall, M. Hlatky, W. Y.W. Lew, J. A.C. Lima, A. S. Maisel, et al.
Highlights of the Year in JACC 2009
J. Am. Coll. Cardiol.,
January 26, 2010;
55(4):
380 - 407.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. W. Lindsey, W. J. Parks, B. E. Kogon, D. Sallee III, and W. T. Mahle
Pulmonary Valve Replacement After Tetralogy of Fallot Repair in Preadolescent Patients
Ann. Thorac. Surg.,
January 1, 2010;
89(1):
147 - 151.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
