Hybrid pulmonary artery plication followed by transcatheter pulmonary valve replacement: Comparison with surgical PVR
Objective/Background Historically, the sole option for patients with a dysfunctional native right ventricular outflow tract (RVOT) requiring re‐establishment of pulmonary competence has been surgical PVR. We sought to compare early outcomes of hybrid pulmonary valve replacement (PVR) combining surgi...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2016-11, Vol.88 (5), p.804-810 |
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| container_title | Catheterization and cardiovascular interventions |
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| creator | Sosnowski, Cyndi Matella, Thomas Fogg, Louis Ilbawi, Michel Nagaraj, Hosakote Kavinsky, Clifford Wolf, Andrew R Diab, Karim Caputo, Massimo Kenny, Damien |
| description | Objective/Background
Historically, the sole option for patients with a dysfunctional native right ventricular outflow tract (RVOT) requiring re‐establishment of pulmonary competence has been surgical PVR. We sought to compare early outcomes of hybrid pulmonary valve replacement (PVR) combining surgical plication of the main pulmonary artery followed by transcatheter PVR, with a contemporary cohort of surgical PVR patients.
Methods
Retrospective chart analysis of all patients with a dilated native RVOT eligible for surgical PVR over 36 months was performed. The cohorts included patients with previous tetralogy of Fallot repair (n = 14), and previous intervention for congenital abnormality of the pulmonary valve (n = 7).
Results
Twenty‐one patients with a dysfunctional native RVOT met criteria for PVR; 8 using the hybrid procedure (group 1: age, 31.5 +/− 17.4 years) and 13 with cardiopulmonary bypass (CPB) (group 2: age, 31 +/− 18.4 years). Valve delivery was successful in all patients with no procedural mortality. Group 1 had a lesser requirement for blood products (P =< 0.001) and a trend toward shorter hospital stay and higher post‐operative hemoglobin. No patients in group 1 received inotropic support post‐operatively compared to 54% of patients in group 2. Mean follow‐up was 3.4 months for group 1 and 13.6 months for group 2 with the average peak gradient across the RVOT of 20.1 and 15.1 mm Hg respectively (P = 0.12), all with no more than mild PI.
Conclusions
Transcatheter hybrid PVR following RVOT plication provides a reasonable alternative to surgical PVR particularly in higher risk cohorts, reducing possible longer‐term consequences of repeated runs of CPB. © 2016 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/ccd.26620 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1841798390</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1841798390</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3910-eaf22b508258501cb91f40cc809040fb4821e43915a4b1c6503d7021c322943</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhS0Eoj-w4AWQJTZ0kfb6L4nZVQE6SAWqgoCd5TgOdXHiYCcd5u1xmWmFkFhdy_rOJ18fhJ4ROCYA9MSY7piWJYUHaJ8ISouKlt8e7s5E8nIPHaR0DQCypPIx2qOVYAIk30fLatNG1-Fp8UMYddxgHWebx-Sd0bMLI-6D92FtO9xu8Bz1mPL9lc3QX6Eb7W8sjnby2tjBjvMr3IRh0tGlbFi7-QqnJX7PSo8vvlw-QY967ZN9upuH6NPbN5-bVXH-8exdc3peGCYJFFb3lLYCaipqAcS0kvQcjKlBAoe-5TUllmdUaN4SUwpgXQWUGEap5OwQvdxapxh-LjbNanDJWO_1aMOSFKk5qWTNJGT0xT_odVjimN92S_FKUM5Ipo62lIkhpWh7NUU35P0VAXXbhMpNqD9NZPb5zri0g-3uybuvz8DJFlg7bzf_N6mmeX2nLLYJl2b76z6h4w9VVqwS6uuHMyUuWX3B3q8UsN8qI6Fq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1844752431</pqid></control><display><type>article</type><title>Hybrid pulmonary artery plication followed by transcatheter pulmonary valve replacement: Comparison with surgical PVR</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Sosnowski, Cyndi ; Matella, Thomas ; Fogg, Louis ; Ilbawi, Michel ; Nagaraj, Hosakote ; Kavinsky, Clifford ; Wolf, Andrew R ; Diab, Karim ; Caputo, Massimo ; Kenny, Damien</creator><creatorcontrib>Sosnowski, Cyndi ; Matella, Thomas ; Fogg, Louis ; Ilbawi, Michel ; Nagaraj, Hosakote ; Kavinsky, Clifford ; Wolf, Andrew R ; Diab, Karim ; Caputo, Massimo ; Kenny, Damien</creatorcontrib><description>Objective/Background
Historically, the sole option for patients with a dysfunctional native right ventricular outflow tract (RVOT) requiring re‐establishment of pulmonary competence has been surgical PVR. We sought to compare early outcomes of hybrid pulmonary valve replacement (PVR) combining surgical plication of the main pulmonary artery followed by transcatheter PVR, with a contemporary cohort of surgical PVR patients.
Methods
Retrospective chart analysis of all patients with a dilated native RVOT eligible for surgical PVR over 36 months was performed. The cohorts included patients with previous tetralogy of Fallot repair (n = 14), and previous intervention for congenital abnormality of the pulmonary valve (n = 7).
Results
Twenty‐one patients with a dysfunctional native RVOT met criteria for PVR; 8 using the hybrid procedure (group 1: age, 31.5 +/− 17.4 years) and 13 with cardiopulmonary bypass (CPB) (group 2: age, 31 +/− 18.4 years). Valve delivery was successful in all patients with no procedural mortality. Group 1 had a lesser requirement for blood products (P =< 0.001) and a trend toward shorter hospital stay and higher post‐operative hemoglobin. No patients in group 1 received inotropic support post‐operatively compared to 54% of patients in group 2. Mean follow‐up was 3.4 months for group 1 and 13.6 months for group 2 with the average peak gradient across the RVOT of 20.1 and 15.1 mm Hg respectively (P = 0.12), all with no more than mild PI.
Conclusions
Transcatheter hybrid PVR following RVOT plication provides a reasonable alternative to surgical PVR particularly in higher risk cohorts, reducing possible longer‐term consequences of repeated runs of CPB. © 2016 Wiley Periodicals, Inc.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.26620</identifier><identifier>PMID: 27535094</identifier><identifier>CODEN: CARIF2</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Angiography ; Bioprosthesis ; Cardiac Catheterization - methods ; Child ; Child, Preschool ; Echocardiography ; Female ; Follow-Up Studies ; Heart Valve Prosthesis Implantation - methods ; Humans ; hybrid pulmonary valve replacement ; Male ; melody valve ; Middle Aged ; Pulmonary Artery - diagnostic imaging ; Pulmonary Artery - surgery ; Pulmonary Valve - diagnostic imaging ; Pulmonary Valve - surgery ; Pulmonary Valve Insufficiency - diagnosis ; Pulmonary Valve Insufficiency - surgery ; pulmonary valve replacement ; Retrospective Studies ; Tetralogy of Fallot ; Treatment Outcome ; Vascular Surgical Procedures - methods ; Young Adult</subject><ispartof>Catheterization and cardiovascular interventions, 2016-11, Vol.88 (5), p.804-810</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3910-eaf22b508258501cb91f40cc809040fb4821e43915a4b1c6503d7021c322943</citedby><cites>FETCH-LOGICAL-c3910-eaf22b508258501cb91f40cc809040fb4821e43915a4b1c6503d7021c322943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.26620$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.26620$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27535094$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sosnowski, Cyndi</creatorcontrib><creatorcontrib>Matella, Thomas</creatorcontrib><creatorcontrib>Fogg, Louis</creatorcontrib><creatorcontrib>Ilbawi, Michel</creatorcontrib><creatorcontrib>Nagaraj, Hosakote</creatorcontrib><creatorcontrib>Kavinsky, Clifford</creatorcontrib><creatorcontrib>Wolf, Andrew R</creatorcontrib><creatorcontrib>Diab, Karim</creatorcontrib><creatorcontrib>Caputo, Massimo</creatorcontrib><creatorcontrib>Kenny, Damien</creatorcontrib><title>Hybrid pulmonary artery plication followed by transcatheter pulmonary valve replacement: Comparison with surgical PVR</title><title>Catheterization and cardiovascular interventions</title><addtitle>Cathet. Cardiovasc. Intervent</addtitle><description>Objective/Background
Historically, the sole option for patients with a dysfunctional native right ventricular outflow tract (RVOT) requiring re‐establishment of pulmonary competence has been surgical PVR. We sought to compare early outcomes of hybrid pulmonary valve replacement (PVR) combining surgical plication of the main pulmonary artery followed by transcatheter PVR, with a contemporary cohort of surgical PVR patients.
Methods
Retrospective chart analysis of all patients with a dilated native RVOT eligible for surgical PVR over 36 months was performed. The cohorts included patients with previous tetralogy of Fallot repair (n = 14), and previous intervention for congenital abnormality of the pulmonary valve (n = 7).
Results
Twenty‐one patients with a dysfunctional native RVOT met criteria for PVR; 8 using the hybrid procedure (group 1: age, 31.5 +/− 17.4 years) and 13 with cardiopulmonary bypass (CPB) (group 2: age, 31 +/− 18.4 years). Valve delivery was successful in all patients with no procedural mortality. Group 1 had a lesser requirement for blood products (P =< 0.001) and a trend toward shorter hospital stay and higher post‐operative hemoglobin. No patients in group 1 received inotropic support post‐operatively compared to 54% of patients in group 2. Mean follow‐up was 3.4 months for group 1 and 13.6 months for group 2 with the average peak gradient across the RVOT of 20.1 and 15.1 mm Hg respectively (P = 0.12), all with no more than mild PI.
Conclusions
Transcatheter hybrid PVR following RVOT plication provides a reasonable alternative to surgical PVR particularly in higher risk cohorts, reducing possible longer‐term consequences of repeated runs of CPB. © 2016 Wiley Periodicals, Inc.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Angiography</subject><subject>Bioprosthesis</subject><subject>Cardiac Catheterization - methods</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Valve Prosthesis Implantation - methods</subject><subject>Humans</subject><subject>hybrid pulmonary valve replacement</subject><subject>Male</subject><subject>melody valve</subject><subject>Middle Aged</subject><subject>Pulmonary Artery - diagnostic imaging</subject><subject>Pulmonary Artery - surgery</subject><subject>Pulmonary Valve - diagnostic imaging</subject><subject>Pulmonary Valve - surgery</subject><subject>Pulmonary Valve Insufficiency - diagnosis</subject><subject>Pulmonary Valve Insufficiency - surgery</subject><subject>pulmonary valve replacement</subject><subject>Retrospective Studies</subject><subject>Tetralogy of Fallot</subject><subject>Treatment Outcome</subject><subject>Vascular Surgical Procedures - methods</subject><subject>Young Adult</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS0Eoj-w4AWQJTZ0kfb6L4nZVQE6SAWqgoCd5TgOdXHiYCcd5u1xmWmFkFhdy_rOJ18fhJ4ROCYA9MSY7piWJYUHaJ8ISouKlt8e7s5E8nIPHaR0DQCypPIx2qOVYAIk30fLatNG1-Fp8UMYddxgHWebx-Sd0bMLI-6D92FtO9xu8Bz1mPL9lc3QX6Eb7W8sjnby2tjBjvMr3IRh0tGlbFi7-QqnJX7PSo8vvlw-QY967ZN9upuH6NPbN5-bVXH-8exdc3peGCYJFFb3lLYCaipqAcS0kvQcjKlBAoe-5TUllmdUaN4SUwpgXQWUGEap5OwQvdxapxh-LjbNanDJWO_1aMOSFKk5qWTNJGT0xT_odVjimN92S_FKUM5Ipo62lIkhpWh7NUU35P0VAXXbhMpNqD9NZPb5zri0g-3uybuvz8DJFlg7bzf_N6mmeX2nLLYJl2b76z6h4w9VVqwS6uuHMyUuWX3B3q8UsN8qI6Fq</recordid><startdate>201611</startdate><enddate>201611</enddate><creator>Sosnowski, Cyndi</creator><creator>Matella, Thomas</creator><creator>Fogg, Louis</creator><creator>Ilbawi, Michel</creator><creator>Nagaraj, Hosakote</creator><creator>Kavinsky, Clifford</creator><creator>Wolf, Andrew R</creator><creator>Diab, Karim</creator><creator>Caputo, Massimo</creator><creator>Kenny, Damien</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201611</creationdate><title>Hybrid pulmonary artery plication followed by transcatheter pulmonary valve replacement: Comparison with surgical PVR</title><author>Sosnowski, Cyndi ; Matella, Thomas ; Fogg, Louis ; Ilbawi, Michel ; Nagaraj, Hosakote ; Kavinsky, Clifford ; Wolf, Andrew R ; Diab, Karim ; Caputo, Massimo ; Kenny, Damien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3910-eaf22b508258501cb91f40cc809040fb4821e43915a4b1c6503d7021c322943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Angiography</topic><topic>Bioprosthesis</topic><topic>Cardiac Catheterization - methods</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Valve Prosthesis Implantation - methods</topic><topic>Humans</topic><topic>hybrid pulmonary valve replacement</topic><topic>Male</topic><topic>melody valve</topic><topic>Middle Aged</topic><topic>Pulmonary Artery - diagnostic imaging</topic><topic>Pulmonary Artery - surgery</topic><topic>Pulmonary Valve - diagnostic imaging</topic><topic>Pulmonary Valve - surgery</topic><topic>Pulmonary Valve Insufficiency - diagnosis</topic><topic>Pulmonary Valve Insufficiency - surgery</topic><topic>pulmonary valve replacement</topic><topic>Retrospective Studies</topic><topic>Tetralogy of Fallot</topic><topic>Treatment Outcome</topic><topic>Vascular Surgical Procedures - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sosnowski, Cyndi</creatorcontrib><creatorcontrib>Matella, Thomas</creatorcontrib><creatorcontrib>Fogg, Louis</creatorcontrib><creatorcontrib>Ilbawi, Michel</creatorcontrib><creatorcontrib>Nagaraj, Hosakote</creatorcontrib><creatorcontrib>Kavinsky, Clifford</creatorcontrib><creatorcontrib>Wolf, Andrew R</creatorcontrib><creatorcontrib>Diab, Karim</creatorcontrib><creatorcontrib>Caputo, Massimo</creatorcontrib><creatorcontrib>Kenny, Damien</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sosnowski, Cyndi</au><au>Matella, Thomas</au><au>Fogg, Louis</au><au>Ilbawi, Michel</au><au>Nagaraj, Hosakote</au><au>Kavinsky, Clifford</au><au>Wolf, Andrew R</au><au>Diab, Karim</au><au>Caputo, Massimo</au><au>Kenny, Damien</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hybrid pulmonary artery plication followed by transcatheter pulmonary valve replacement: Comparison with surgical PVR</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Cathet. Cardiovasc. Intervent</addtitle><date>2016-11</date><risdate>2016</risdate><volume>88</volume><issue>5</issue><spage>804</spage><epage>810</epage><pages>804-810</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><coden>CARIF2</coden><abstract>Objective/Background
Historically, the sole option for patients with a dysfunctional native right ventricular outflow tract (RVOT) requiring re‐establishment of pulmonary competence has been surgical PVR. We sought to compare early outcomes of hybrid pulmonary valve replacement (PVR) combining surgical plication of the main pulmonary artery followed by transcatheter PVR, with a contemporary cohort of surgical PVR patients.
Methods
Retrospective chart analysis of all patients with a dilated native RVOT eligible for surgical PVR over 36 months was performed. The cohorts included patients with previous tetralogy of Fallot repair (n = 14), and previous intervention for congenital abnormality of the pulmonary valve (n = 7).
Results
Twenty‐one patients with a dysfunctional native RVOT met criteria for PVR; 8 using the hybrid procedure (group 1: age, 31.5 +/− 17.4 years) and 13 with cardiopulmonary bypass (CPB) (group 2: age, 31 +/− 18.4 years). Valve delivery was successful in all patients with no procedural mortality. Group 1 had a lesser requirement for blood products (P =< 0.001) and a trend toward shorter hospital stay and higher post‐operative hemoglobin. No patients in group 1 received inotropic support post‐operatively compared to 54% of patients in group 2. Mean follow‐up was 3.4 months for group 1 and 13.6 months for group 2 with the average peak gradient across the RVOT of 20.1 and 15.1 mm Hg respectively (P = 0.12), all with no more than mild PI.
Conclusions
Transcatheter hybrid PVR following RVOT plication provides a reasonable alternative to surgical PVR particularly in higher risk cohorts, reducing possible longer‐term consequences of repeated runs of CPB. © 2016 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>27535094</pmid><doi>10.1002/ccd.26620</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Angiography Bioprosthesis Cardiac Catheterization - methods Child Child, Preschool Echocardiography Female Follow-Up Studies Heart Valve Prosthesis Implantation - methods Humans hybrid pulmonary valve replacement Male melody valve Middle Aged Pulmonary Artery - diagnostic imaging Pulmonary Artery - surgery Pulmonary Valve - diagnostic imaging Pulmonary Valve - surgery Pulmonary Valve Insufficiency - diagnosis Pulmonary Valve Insufficiency - surgery pulmonary valve replacement Retrospective Studies Tetralogy of Fallot Treatment Outcome Vascular Surgical Procedures - methods Young Adult |
| title | Hybrid pulmonary artery plication followed by transcatheter pulmonary valve replacement: Comparison with surgical PVR |
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