Modified technique of percutaneous pulmonary valve implantation with the Sapien 3: Impact on procedure and early outcome - 14/08/21
, Clément Batteux, MD 1, Emre Belli, MD 1, Clément Karsenty, MD 4, Jérôme Petit, MD 1, Sébastien Hascoët, MD, PhD 1
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.
Conéctese para beneficiarse!
Resumen |
Introduction |
Percutaneous pulmonary valve implantation (PPVI) with Sapien 3 valve is effective to treat right ventricle outflow (RVOT) dysfunction. Issues related to presenting and tricuspid valve injuries were reported with the initial implantation method. A modified technique was developed without pre-stenting and with a protective delivery method for valve implantation.
Methods |
We aimed to compare procedural results in the modified technique group (MTG) to matched patients in a conventional technique group (CTG). All consecutive procedures performed in the MTG over 9months were matched based on RVOT type and size to consecutive procedures performed before.
Results |
Twenty-seven patients were included in each group. Size of the Sapien 3 valves were 23mm (n=9), 26mm (n=9), 29mm (n=36). The two groups were similar regarding demographic data, RVOT type, pre-procedure hemodynamics (Table 1). PPVI was performed in a single procedure in all patients of the MTG, whereas six (22.2%) patients of the CTG group had pre-stenting as a first step and valve implantation later (P=0.02). Procedures were successful in all cases. Stent embolization was reported in two patients (7.4%) in the CTG, which were impacted in pulmonary arteries. Instability of a valve was observed in one case (3.7%) in the MTG, stabilized with two stents and an additional valve-in-valve implantation. Hemodynamics results were good in all cases without significant difference among the two groups (Table 2).
Procedure duration and fluoroscopy times were significantly reduced in the MTG (48.1 versus 82.6minutes, P<0.0001; 15.2 versus 29.8minutes, P=0.0002).
During follow-up, no stent fracture or valve dysfunction was noticed in both groups.
Conclusion |
PPVI without pre-stenting and with a protective delivery method of the Sapien 3 valve reduces significantly the procedure complexity, procedure duration and irradiation, while maintaining excellent hemodynamics results.
El texto completo de este artículo está disponible en PDF.Esquema
Vol 13 - N° 4
P. 315-316 - septembre 2021 Regresar al número
Artículo precedente
- Total cavopulmonary connection procedure in adults: A review of the medical literature
- Hichem Sakhi, Sébastien Hascoët, Emre Belli, Meriem Kara, Emmanuelle Fournier, Régine Roussin, Sarah Cohen
- A false left ventricular non-compaction; Late discovery of a corrected transposition of the great vessels in a 63-year-old patient
- F. Saadi, B. Baloul, S. Hamadouche, B.V. Tung, N. Ghanem, V. Dormagen, G. Karrillon
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.