The adaptability of the Pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease
Background Pulsta valve is increasingly used for percutaneous pulmonary valve implantation (PPVI) in patients with a large native right ventricular outflow tract (RVOT). This study aims to elucidate the outcomes of Pulsta valve implantation within the native RVOT and assess its adaptability to vario...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2024-03, Vol.103 (4), p.587-596 |
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| creator | Park, Woo Young Kim, Gi Beom Lee, Sang Yun Kim, Ah Young Choi, Jae Young Jang, So Ick Kim, Seong Ho Cha, Seul Gi Wang, Jou‐Kou Lin, Ming‐Tai Chen, Chun‐An |
| description | Background
Pulsta valve is increasingly used for percutaneous pulmonary valve implantation (PPVI) in patients with a large native right ventricular outflow tract (RVOT). This study aims to elucidate the outcomes of Pulsta valve implantation within the native RVOT and assess its adaptability to various native main pulmonary artery (PA) anatomies.
Methods
A multicenter retrospective study included 182 patients with moderate to severe pulmonary regurgitation in the native RVOT who underwent PPVI with Pulsta valves® between February 2016 and August 2023 at five Korean and Taiwanese tertiary referral centers.
Results
Pulsta valve implantation was successful in 179 out of 182 patients (98.4%) with an average age of 26.7 ± 11.0 years. The median follow‐up duration was 29 months. Baseline assessments revealed enlarged right ventricle (RV) volume (mean indexed RV end‐diastolic volume: 163.1 (interquartile range, IQR: 152.0–180.3 mL/m²), which significantly decreased to 123.6(IQR: 106.6–137.5 mL/m2 after 1 year. The main PA types were classified as pyramidal (3.8%), straight (38.5%), reverse pyramidal (13.2%), convex (26.4%), and concave (18.1%) shapes. Pulsta valve placement was adapted, with distal main PA for pyramidal shapes and proximal or mid‐PA for reverse pyramidal shapes. Two patients experienced Pulsta valve embolization to RV, requiring surgical removal, and one patient encountered valve migration to the distal main PA, necessitating surgical fixation.
Conclusions
Customized valve insertion sites are pivotal in self‐expandable PPVI considering diverse native RVOT shape. The rather soft and compact structure of the Pulsta valve has characteristics to are adaptable to diverse native RVOT geometries. |
| doi_str_mv | 10.1002/ccd.30968 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2925033501</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2925033501</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3138-265292b011f563269430ebc99b5845a4a5b5b66e52fc0aedb5db3cdfa4ad02453</originalsourceid><addsrcrecordid>eNp1kU1P3DAQhq2qqHy0h_4BZKmXcljwR2ySY7VtAQmpPVCpt2jsTLpGTpzazqI98s8x7MIBidOMxs88Gvkl5DNnp5wxcWZtdypZo-t35IArIRbnQv99v-t5U-l9cpjSLWOFEc0Hsi9rWXEtqgNyf7NCCh1MGYzzLm9o6Gkus9-zTxnoGvwaaQ5Ps86tMSakA7iRTrMfwghxQyFmLCWtYMLH9RFyAWl0_1aZrnHM0dnZQ6Rhzr0PdzRHsLnYEkLCj2SvB5_w064ekT8_f9wsLxfXvy6ult-uF1ZyWS-EVqIRhnHeKy2FbirJ0NimMaquFFSgjDJaoxK9ZYCdUZ2RtuvLS8dEpeQR-br1TjH8nzHldnDJovcwYphTW-yKSakYL-iXV-htmONYriuUqkXFFNeFOtlSNoaUIvbtFN1QPqTlrH3MpS25tE-5FPZ4Z5zNgN0L-RxEAc62wJ3zuHnb1C6X37fKB3fAmF4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2958240516</pqid></control><display><type>article</type><title>The adaptability of the Pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Park, Woo Young ; Kim, Gi Beom ; Lee, Sang Yun ; Kim, Ah Young ; Choi, Jae Young ; Jang, So Ick ; Kim, Seong Ho ; Cha, Seul Gi ; Wang, Jou‐Kou ; Lin, Ming‐Tai ; Chen, Chun‐An</creator><creatorcontrib>Park, Woo Young ; Kim, Gi Beom ; Lee, Sang Yun ; Kim, Ah Young ; Choi, Jae Young ; Jang, So Ick ; Kim, Seong Ho ; Cha, Seul Gi ; Wang, Jou‐Kou ; Lin, Ming‐Tai ; Chen, Chun‐An</creatorcontrib><description>Background
Pulsta valve is increasingly used for percutaneous pulmonary valve implantation (PPVI) in patients with a large native right ventricular outflow tract (RVOT). This study aims to elucidate the outcomes of Pulsta valve implantation within the native RVOT and assess its adaptability to various native main pulmonary artery (PA) anatomies.
Methods
A multicenter retrospective study included 182 patients with moderate to severe pulmonary regurgitation in the native RVOT who underwent PPVI with Pulsta valves® between February 2016 and August 2023 at five Korean and Taiwanese tertiary referral centers.
Results
Pulsta valve implantation was successful in 179 out of 182 patients (98.4%) with an average age of 26.7 ± 11.0 years. The median follow‐up duration was 29 months. Baseline assessments revealed enlarged right ventricle (RV) volume (mean indexed RV end‐diastolic volume: 163.1 (interquartile range, IQR: 152.0–180.3 mL/m²), which significantly decreased to 123.6(IQR: 106.6–137.5 mL/m2 after 1 year. The main PA types were classified as pyramidal (3.8%), straight (38.5%), reverse pyramidal (13.2%), convex (26.4%), and concave (18.1%) shapes. Pulsta valve placement was adapted, with distal main PA for pyramidal shapes and proximal or mid‐PA for reverse pyramidal shapes. Two patients experienced Pulsta valve embolization to RV, requiring surgical removal, and one patient encountered valve migration to the distal main PA, necessitating surgical fixation.
Conclusions
Customized valve insertion sites are pivotal in self‐expandable PPVI considering diverse native RVOT shape. The rather soft and compact structure of the Pulsta valve has characteristics to are adaptable to diverse native RVOT geometries.</description><identifier>ISSN: 1522-1946</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.30968</identifier><identifier>PMID: 38341624</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adaptability ; Adolescent ; Adult ; Cardiac Catheterization ; congenital heart disease ; Embolization ; Heart ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation - adverse effects ; Heart Ventricles ; Humans ; native right ventricular outflow tract type ; percutaneous pulmonary valve implantation ; Pulmonary arteries ; Pulmonary artery ; Pulmonary Artery - diagnostic imaging ; Pulmonary Artery - surgery ; pulmonary regurgitation ; Pulmonary Valve - diagnostic imaging ; Pulmonary Valve - surgery ; Pulmonary Valve Insufficiency - diagnostic imaging ; Pulmonary Valve Insufficiency - etiology ; Pulmonary Valve Insufficiency - surgery ; Regurgitation ; Retrospective Studies ; Treatment Outcome ; Ventricle ; Young Adult</subject><ispartof>Catheterization and cardiovascular interventions, 2024-03, Vol.103 (4), p.587-596</ispartof><rights>2024 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3138-265292b011f563269430ebc99b5845a4a5b5b66e52fc0aedb5db3cdfa4ad02453</cites><orcidid>0000-0002-2371-7042 ; 0000-0002-7880-280X ; 0000-0002-3071-2661 ; 0000-0002-1718-7137 ; 0000-0002-0713-4461 ; 0000-0001-8880-7113 ; 0000-0001-7470-9774 ; 0000-0002-5933-1010 ; 0000-0002-1247-6669 ; 0000-0002-8938-1596 ; 0000-0002-3043-3873</orcidid></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.30968$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.30968$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38341624$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Woo Young</creatorcontrib><creatorcontrib>Kim, Gi Beom</creatorcontrib><creatorcontrib>Lee, Sang Yun</creatorcontrib><creatorcontrib>Kim, Ah Young</creatorcontrib><creatorcontrib>Choi, Jae Young</creatorcontrib><creatorcontrib>Jang, So Ick</creatorcontrib><creatorcontrib>Kim, Seong Ho</creatorcontrib><creatorcontrib>Cha, Seul Gi</creatorcontrib><creatorcontrib>Wang, Jou‐Kou</creatorcontrib><creatorcontrib>Lin, Ming‐Tai</creatorcontrib><creatorcontrib>Chen, Chun‐An</creatorcontrib><title>The adaptability of the Pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Background
Pulsta valve is increasingly used for percutaneous pulmonary valve implantation (PPVI) in patients with a large native right ventricular outflow tract (RVOT). This study aims to elucidate the outcomes of Pulsta valve implantation within the native RVOT and assess its adaptability to various native main pulmonary artery (PA) anatomies.
Methods
A multicenter retrospective study included 182 patients with moderate to severe pulmonary regurgitation in the native RVOT who underwent PPVI with Pulsta valves® between February 2016 and August 2023 at five Korean and Taiwanese tertiary referral centers.
Results
Pulsta valve implantation was successful in 179 out of 182 patients (98.4%) with an average age of 26.7 ± 11.0 years. The median follow‐up duration was 29 months. Baseline assessments revealed enlarged right ventricle (RV) volume (mean indexed RV end‐diastolic volume: 163.1 (interquartile range, IQR: 152.0–180.3 mL/m²), which significantly decreased to 123.6(IQR: 106.6–137.5 mL/m2 after 1 year. The main PA types were classified as pyramidal (3.8%), straight (38.5%), reverse pyramidal (13.2%), convex (26.4%), and concave (18.1%) shapes. Pulsta valve placement was adapted, with distal main PA for pyramidal shapes and proximal or mid‐PA for reverse pyramidal shapes. Two patients experienced Pulsta valve embolization to RV, requiring surgical removal, and one patient encountered valve migration to the distal main PA, necessitating surgical fixation.
Conclusions
Customized valve insertion sites are pivotal in self‐expandable PPVI considering diverse native RVOT shape. The rather soft and compact structure of the Pulsta valve has characteristics to are adaptable to diverse native RVOT geometries.</description><subject>Adaptability</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Cardiac Catheterization</subject><subject>congenital heart disease</subject><subject>Embolization</subject><subject>Heart</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Heart Ventricles</subject><subject>Humans</subject><subject>native right ventricular outflow tract type</subject><subject>percutaneous pulmonary valve implantation</subject><subject>Pulmonary arteries</subject><subject>Pulmonary artery</subject><subject>Pulmonary Artery - diagnostic imaging</subject><subject>Pulmonary Artery - surgery</subject><subject>pulmonary regurgitation</subject><subject>Pulmonary Valve - diagnostic imaging</subject><subject>Pulmonary Valve - surgery</subject><subject>Pulmonary Valve Insufficiency - diagnostic imaging</subject><subject>Pulmonary Valve Insufficiency - etiology</subject><subject>Pulmonary Valve Insufficiency - surgery</subject><subject>Regurgitation</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><subject>Young Adult</subject><issn>1522-1946</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1P3DAQhq2qqHy0h_4BZKmXcljwR2ySY7VtAQmpPVCpt2jsTLpGTpzazqI98s8x7MIBidOMxs88Gvkl5DNnp5wxcWZtdypZo-t35IArIRbnQv99v-t5U-l9cpjSLWOFEc0Hsi9rWXEtqgNyf7NCCh1MGYzzLm9o6Gkus9-zTxnoGvwaaQ5Ps86tMSakA7iRTrMfwghxQyFmLCWtYMLH9RFyAWl0_1aZrnHM0dnZQ6Rhzr0PdzRHsLnYEkLCj2SvB5_w064ekT8_f9wsLxfXvy6ult-uF1ZyWS-EVqIRhnHeKy2FbirJ0NimMaquFFSgjDJaoxK9ZYCdUZ2RtuvLS8dEpeQR-br1TjH8nzHldnDJovcwYphTW-yKSakYL-iXV-htmONYriuUqkXFFNeFOtlSNoaUIvbtFN1QPqTlrH3MpS25tE-5FPZ4Z5zNgN0L-RxEAc62wJ3zuHnb1C6X37fKB3fAmF4</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Park, Woo Young</creator><creator>Kim, Gi Beom</creator><creator>Lee, Sang Yun</creator><creator>Kim, Ah Young</creator><creator>Choi, Jae Young</creator><creator>Jang, So Ick</creator><creator>Kim, Seong Ho</creator><creator>Cha, Seul Gi</creator><creator>Wang, Jou‐Kou</creator><creator>Lin, Ming‐Tai</creator><creator>Chen, Chun‐An</creator><general>Wiley Subscription Services, Inc</general><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><orcidid>https://orcid.org/0000-0002-2371-7042</orcidid><orcidid>https://orcid.org/0000-0002-7880-280X</orcidid><orcidid>https://orcid.org/0000-0002-3071-2661</orcidid><orcidid>https://orcid.org/0000-0002-1718-7137</orcidid><orcidid>https://orcid.org/0000-0002-0713-4461</orcidid><orcidid>https://orcid.org/0000-0001-8880-7113</orcidid><orcidid>https://orcid.org/0000-0001-7470-9774</orcidid><orcidid>https://orcid.org/0000-0002-5933-1010</orcidid><orcidid>https://orcid.org/0000-0002-1247-6669</orcidid><orcidid>https://orcid.org/0000-0002-8938-1596</orcidid><orcidid>https://orcid.org/0000-0002-3043-3873</orcidid></search><sort><creationdate>20240301</creationdate><title>The adaptability of the Pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease</title><author>Park, Woo Young ; Kim, Gi Beom ; Lee, Sang Yun ; Kim, Ah Young ; Choi, Jae Young ; Jang, So Ick ; Kim, Seong Ho ; Cha, Seul Gi ; Wang, Jou‐Kou ; Lin, Ming‐Tai ; Chen, Chun‐An</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3138-265292b011f563269430ebc99b5845a4a5b5b66e52fc0aedb5db3cdfa4ad02453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adaptability</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Cardiac Catheterization</topic><topic>congenital heart disease</topic><topic>Embolization</topic><topic>Heart</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation - adverse effects</topic><topic>Heart Ventricles</topic><topic>Humans</topic><topic>native right ventricular outflow tract type</topic><topic>percutaneous pulmonary valve implantation</topic><topic>Pulmonary arteries</topic><topic>Pulmonary artery</topic><topic>Pulmonary Artery - diagnostic imaging</topic><topic>Pulmonary Artery - surgery</topic><topic>pulmonary regurgitation</topic><topic>Pulmonary Valve - diagnostic imaging</topic><topic>Pulmonary Valve - surgery</topic><topic>Pulmonary Valve Insufficiency - diagnostic imaging</topic><topic>Pulmonary Valve Insufficiency - etiology</topic><topic>Pulmonary Valve Insufficiency - surgery</topic><topic>Regurgitation</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>Ventricle</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Woo Young</creatorcontrib><creatorcontrib>Kim, Gi Beom</creatorcontrib><creatorcontrib>Lee, Sang Yun</creatorcontrib><creatorcontrib>Kim, Ah Young</creatorcontrib><creatorcontrib>Choi, Jae Young</creatorcontrib><creatorcontrib>Jang, So Ick</creatorcontrib><creatorcontrib>Kim, Seong Ho</creatorcontrib><creatorcontrib>Cha, Seul Gi</creatorcontrib><creatorcontrib>Wang, Jou‐Kou</creatorcontrib><creatorcontrib>Lin, Ming‐Tai</creatorcontrib><creatorcontrib>Chen, Chun‐An</creatorcontrib><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>Park, Woo Young</au><au>Kim, Gi Beom</au><au>Lee, Sang Yun</au><au>Kim, Ah Young</au><au>Choi, Jae Young</au><au>Jang, So Ick</au><au>Kim, Seong Ho</au><au>Cha, Seul Gi</au><au>Wang, Jou‐Kou</au><au>Lin, Ming‐Tai</au><au>Chen, Chun‐An</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The adaptability of the Pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>103</volume><issue>4</issue><spage>587</spage><epage>596</epage><pages>587-596</pages><issn>1522-1946</issn><eissn>1522-726X</eissn><abstract>Background
Pulsta valve is increasingly used for percutaneous pulmonary valve implantation (PPVI) in patients with a large native right ventricular outflow tract (RVOT). This study aims to elucidate the outcomes of Pulsta valve implantation within the native RVOT and assess its adaptability to various native main pulmonary artery (PA) anatomies.
Methods
A multicenter retrospective study included 182 patients with moderate to severe pulmonary regurgitation in the native RVOT who underwent PPVI with Pulsta valves® between February 2016 and August 2023 at five Korean and Taiwanese tertiary referral centers.
Results
Pulsta valve implantation was successful in 179 out of 182 patients (98.4%) with an average age of 26.7 ± 11.0 years. The median follow‐up duration was 29 months. Baseline assessments revealed enlarged right ventricle (RV) volume (mean indexed RV end‐diastolic volume: 163.1 (interquartile range, IQR: 152.0–180.3 mL/m²), which significantly decreased to 123.6(IQR: 106.6–137.5 mL/m2 after 1 year. The main PA types were classified as pyramidal (3.8%), straight (38.5%), reverse pyramidal (13.2%), convex (26.4%), and concave (18.1%) shapes. Pulsta valve placement was adapted, with distal main PA for pyramidal shapes and proximal or mid‐PA for reverse pyramidal shapes. Two patients experienced Pulsta valve embolization to RV, requiring surgical removal, and one patient encountered valve migration to the distal main PA, necessitating surgical fixation.
Conclusions
Customized valve insertion sites are pivotal in self‐expandable PPVI considering diverse native RVOT shape. The rather soft and compact structure of the Pulsta valve has characteristics to are adaptable to diverse native RVOT geometries.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38341624</pmid><doi>10.1002/ccd.30968</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-2371-7042</orcidid><orcidid>https://orcid.org/0000-0002-7880-280X</orcidid><orcidid>https://orcid.org/0000-0002-3071-2661</orcidid><orcidid>https://orcid.org/0000-0002-1718-7137</orcidid><orcidid>https://orcid.org/0000-0002-0713-4461</orcidid><orcidid>https://orcid.org/0000-0001-8880-7113</orcidid><orcidid>https://orcid.org/0000-0001-7470-9774</orcidid><orcidid>https://orcid.org/0000-0002-5933-1010</orcidid><orcidid>https://orcid.org/0000-0002-1247-6669</orcidid><orcidid>https://orcid.org/0000-0002-8938-1596</orcidid><orcidid>https://orcid.org/0000-0002-3043-3873</orcidid></addata></record> |
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| subjects | Adaptability Adolescent Adult Cardiac Catheterization congenital heart disease Embolization Heart Heart Valve Prosthesis Heart Valve Prosthesis Implantation - adverse effects Heart Ventricles Humans native right ventricular outflow tract type percutaneous pulmonary valve implantation Pulmonary arteries Pulmonary artery Pulmonary Artery - diagnostic imaging Pulmonary Artery - surgery pulmonary regurgitation Pulmonary Valve - diagnostic imaging Pulmonary Valve - surgery Pulmonary Valve Insufficiency - diagnostic imaging Pulmonary Valve Insufficiency - etiology Pulmonary Valve Insufficiency - surgery Regurgitation Retrospective Studies Treatment Outcome Ventricle Young Adult |
| title | The adaptability of the Pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease |
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