ABSTRACT
Transcatheter pulmonary valve insertion is the most important advance in congenital interventional cardiology since atrial septal defect devices became commonly available 15 years ago. It has changed the way we look at a number of diverse diagnoses and changes how we plan, diagnose, operate, and follow-up patients. It has changed how we counsel families expecting a child that may benefit from it. Expanded use of the Melody® valve, outside its United States Food and Drug Administration approved indications, has helped numerous additional patients. The use of transcatheter pulmonary valve insertion in selected patients following surgical Gore-tex® bileaflet in valve right ventricular outflow tract reconstruction and those with a history of prior small homograft conduits will be discussed.
Subject(s)
Cardiac Catheterization/methods , Heart Valve Prosthesis Implantation/methods , Pulmonary Artery/surgery , Pulmonary Valve Insufficiency/surgery , Pulmonary Valve Stenosis/surgery , Pulmonary Valve/surgery , Ventricular Outflow Obstruction/surgery , Adolescent , Adult , Child , Cohort Studies , Female , Humans , Male , Retrospective Studies , Young AdultABSTRACT
Transcatheter pulmonary valve replacement with the Melody® valve is an accepted alternative to surgical replacement of the pulmonary valve for some patients and therefore a complementary strategy in the long-term management of several groups of patients with congenital heart disease. It allows at least extending the time between sternotomies and possibly improving late outcomes. With a combined surgical and percutaneous approach, late morbidity for some of these patients will likely be diminished. This manuscript will review the current expanded applications for this technology, demonstrate several examples of its use and discuss future directions for this evolving equipment.
Subject(s)
Heart Valve Prosthesis Implantation/methods , Heart Valve Prosthesis Implantation/trends , Pulmonary Valve/surgery , Adult , Catheterization , Child , Female , Forecasting , Humans , Male , Retrospective StudiesABSTRACT
Cardiac catheterisation continues to play an important role in the long-term management of patients with common arterial trunk and transposition of the great arteries. Although non-invasive imaging has largely eliminated the need for diagnostic catheterisation in newborns with these congenital cardiac lesions, cardiac catheterisation is an important tool for the diagnosis of a variety of problems encountered after surgical intervention, and allows interventions to be performed when feasible. We review the indications for cardiac catheterisation and describe the specifics for various interventional procedures for these patients in this manuscript.
Subject(s)
Cardiac Catheterization/methods , Transposition of Great Vessels/diagnosis , Truncus Arteriosus, Persistent/diagnosis , Coronary Angiography , Humans , Infant, Newborn , Transposition of Great Vessels/surgery , Truncus Arteriosus, Persistent/surgeryABSTRACT
Transcatheter pulmonary valve replacement is fast becoming an accepted alternative to repeat surgical pulmonary valve replacement for selected patients and therefore a complementary strategy in the long-term management of those requiring surgical pulmonary valve replacement. With a combined surgical and percutaneous approach, late morbidity for some of these patients may be diminished. This manuscript will review the current indications for this procedure, its limitations, and its benefits.
Subject(s)
Cardiac Catheterization , Heart Valve Prosthesis Implantation/methods , Pulmonary Valve Stenosis/congenital , Pulmonary Valve Stenosis/surgery , Pulmonary Valve/surgery , Humans , Infant, Newborn , StentsABSTRACT
The hybrid approach to the treatment of patients with hypoplastic left heart syndrome most commonly includes transcatheter placement of a stent in the arterial duct and surgical placement of bands on the branch pulmonary arteries via median sternotomy. This manuscript will review the concept of hybrid palliation and discuss topics related to several time intervals: peri-procedural, post-procedural, interstage, and comprehensive stage 2.
