Project description:BackgroundVarying rates of nonsustained ventricular tachycardia (NSVT) have been reported early after transcatheter pulmonary valve replacement (TPVR) with the Harmony valve, but data regarding rhythm outcomes beyond hospital discharge are limited. This study aims to characterize ventricular arrhythmias after Harmony TPVR from implant through mid-term follow-up.MethodsVentricular arrhythmia data from postimplant telemetry and follow-up extended rhythm monitoring (ERM) were analyzed after Harmony TPVR.ResultsFifty-four patients with tetralogy of Fallot (n=39), valvar pulmonary stenosis (n=10), or pulmonary atresia with intact ventricular septum (n=5) were studied; 22% had prior NSVT and 24% were on prior rhythm medication. On postimplant telemetry, 27 patients (50%) had NSVT, including 1 who had torsade de pointes, but most had <5 episodes. Pre-TPVR NSVT or rhythm medications, diagnosis other than tetralogy, and substantial device contact with the myocardium were associated with more frequent NSVT on telemetry. Ten patients (19%) were started on a new antiarrhythmic medication. On discharge ERM, 37% of patients had NSVT, most with <5 episodes and only 13% with NSVT beyond 5 days post-discharge. On follow-up ERM, 14% of patients had a single episode of NSVT and 1 had 5 episodes. During follow-up, antiarrhythmic medications were discontinued in 8 of 10 patients and no patients died or had sustained ventricular tachycardia.ConclusionsNSVT and ventricular ectopy were common early after TPVR but were infrequent in most cases and diminished rapidly after discharge. The incidence of NSVT on follow-up ERM was similar to preimplant incidence. Few patients had antiarrhythmic medications initiated, and most were discontinued on follow-up. There were no major arrhythmic events after discharge.

| S-EPMC11748900 | biostudies-literature

Transcatheter pulmonary valve replacement.

Project description:Transcatheter pulmonary valve replacement (tPVR) has evolved into a viable alternative to surgical conduit or bioprosthetic valve replacement. This procedure has paved the way for a more advanced approach to congenital and structural interventional cardiology. Although many successes have been noted, there are still a number of challenges with this procedure, including large delivery systems, the need for a conduit or a bioprosthetic valve as a landing zone for the valve, optimal timing of the procedure to prevent right ventricular failure, arrhythmias, and possible death. Research is ongoing to broaden the use of this technology when treating patients with dilated right ventricular outflow tracts, and early experience with a self-expanding valve model has been reported. Affordability is an important factor that must be considered especially in developing nations. The aim of this review is to emphasize the advancement of tPVR, the benefits and challenges of valve implantation, the current state, and the future innovations associated with this approach.

| S-EPMC4107445 | biostudies-literature

Pulmonary Artery Pseudoaneurysm After Transcatheter Pulmonary Valve Replacement, a Novel Approach for Complication Management.

Project description: Not available

| S-EPMC10236866 | biostudies-literature

A first-in-human study of transjugular transcatheter tricuspid valve replacement with the LuX-Valve Plus system.

Project description: Not available

| S-EPMC9909447 | biostudies-literature

Transcatheter pulmonary valve implant in a patient with a previous pulmonary valve-in-valve.

Project description:Increasing numbers of patients with congenital heart disease now survive well into adulthood. Often, these patients already had surgery to correct their congenital lesions from early life. Patients with tetralogy of Fallot commonly require several pulmonary valve replacements in their lifetime. This report highlights the utility of percutaneous pulmonary valve implant inside the two prior prosthetic valves avoiding a third sternotomy, in a young adult patient who developed severe prosthetic pulmonary valve stenosis.Learning objectiveTo understand the potential therapeutic option of transcatheter pulmonary valve implant inside a dilatable stented surgical bioprosthesis with an existing valve-in-valve in situ as part of lifetime management.

| S-EPMC9214873 | biostudies-literature

In-Series Transcatheter Aortic Valve Replacement-in-Transcatheter Aortic Valve Replacement: ACURATE neo Transcatheter Heart Valve Degeneration Successfully Managed with Myval, Avoiding Coronary Flow Obstruction—A Case Report

Project description: Not available

| S-EPMC10512008 | biostudies-literature

A snare maneuver to reposition self-expandable aortic valve after transcatheter replacement of surgically implanted valve.

Project description:In this case, we successfully repositioned the transcatheter heart valve (THV) by pulling it with a snare inserted via the right brachial artery. Attempting to pull the THV via the femoral approach was not successful, due to the vector of the pulling force not being coaxial. Changing the direction of the force by switching to an approach from the right brachial artery successfully prevented perivalvular leakage. While there are previous case reports of repositioning an implanted transcatheter valve in a native valve using a gooseneck snare, to our knowledge, this is the first case of successfully repositioning an implanted transcatheter valve in a valve-in-valve procedure using the precise assessment that can be achieved with intra-procedural transesophageal echocardiography.Learning objectivePerivalvular leakage (PVL) is a major problem after transcatheter aortic valve replacement. In this case, we experienced PVL after implantation of self-expandable transcatheter heart valve (THV) inside the previously inserted Mosaic bioprosthetic valve. Depth of the implanted valve was too low into left ventricle accessed with transesophageal echocardiogram. It is barely known whether THV in surgical implanted aortic valve could be repositioned using snare maneuver, but we successfully pulled the valve via brachial artery and PVL was controlled.

| S-EPMC10730269 | biostudies-literature

Self-Expanding Transcatheter Pulmonary Valve Implant in the Right Pulmonary Artery.

Project description:Newer self-expanding transcatheter pulmonary valves (TPVs) are approved for the treatment of severe pulmonary regurgitation in patients with large right ventricular outflow tracts. We present a patient with Tetralogy of Fallot whose right ventricular outflow tract was too large for self-expanding TPV, who was treated successfully with a self-expanding TPV in the right pulmonary artery. (Level of Difficulty: Advanced.).

| S-EPMC10157103 | biostudies-literature

Femoral artery anatomy-tailored approach in transcatheter aortic valve implantation.

Project description:The best techniques for reduction of femoral access site complications after transcatheter aortic valve implantation (TAVI) remain the object of research.We report on a single center's experience with TAVI performed via the femoral access site.Between September 2010 and September 2015, 152 consecutive patients underwent TAVI in our department. Of them, 101 patients with CoreValve implantation from the femoral access site were included in the analysis. The femoral artery anatomy-tailored approach was introduced in 2013 in order to reduce the rate of access-site complications. Patients were assigned to percutaneous puncture or surgical cut-down depending on the femoral artery anatomy assessed in computed tomography. The study patients were divided into two subgroups: group A - patients treated before January 2013, before introduction of the tailored approach program (n = 34); and group B - patients treated between January 2013 and April 2015 (n = 67).The access site complication rate significantly decreased from 35.3% in group A (n = 12) to 7.5% in group B (n = 5) (p = 0.0012). Both minor and major access site complications were more frequent in group A (p = 0.04 and 0.016, respectively). In-hospital mortality was 8.8% (n = 3) in group A and 1.5% (n = 1) in group B (p = 0.1).The femoral artery anatomy-tailored approach significantly reduces the incidence of access site complications in TAVI patients.

| S-EPMC5545662 | biostudies-other

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