TY - JOUR
T1 - Fracturing a dysfunctional Edwards Perimount bioprosthetic valve to facilitate percutaneous valve-in-valve placement of SAPIEN 3 valve with modified delivery system
AU - Shahanavaz, Shabana
AU - Rockefeller, Toby
AU - Nicolas, Ramzi
AU - Balzer, David
N1 - Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Pulmonary valve replacement via surgical implantation of a bioprosthetic valve (BPV) is a well-established treatment for patients with dysfunctional RV outflow tracts. BPVs are prone to structural deterioration, and will eventually require replacement. Recently, percutaneous valve-in-valve (VIV) placement of transcatheter valves has established itself as a safe and effective alternative to surgical revision. Unfortunately, VIV therapy is inherently limited by the inner diameter of the BPV, which restricts the number of eligible patients. Other centers have reported on the feasibility of cracking certain BPVs with ultra high-pressure balloons in bench testing. We now report cracking an Edwards Perimount BPV in the pulmonary position to facilitate VIV placement of an Edwards SAPIEN 3. The ability to crack the Perimount valve allowed placement of a larger valve than previously considered and minimized the final valve gradient. In an effort to avoid the morbidity and mortality of surgical pulmonary valve replacement, this new strategy will expand the number of patients eligible for percutaneous VIV therapy.
AB - Pulmonary valve replacement via surgical implantation of a bioprosthetic valve (BPV) is a well-established treatment for patients with dysfunctional RV outflow tracts. BPVs are prone to structural deterioration, and will eventually require replacement. Recently, percutaneous valve-in-valve (VIV) placement of transcatheter valves has established itself as a safe and effective alternative to surgical revision. Unfortunately, VIV therapy is inherently limited by the inner diameter of the BPV, which restricts the number of eligible patients. Other centers have reported on the feasibility of cracking certain BPVs with ultra high-pressure balloons in bench testing. We now report cracking an Edwards Perimount BPV in the pulmonary position to facilitate VIV placement of an Edwards SAPIEN 3. The ability to crack the Perimount valve allowed placement of a larger valve than previously considered and minimized the final valve gradient. In an effort to avoid the morbidity and mortality of surgical pulmonary valve replacement, this new strategy will expand the number of patients eligible for percutaneous VIV therapy.
KW - adults
KW - congential heart disease
KW - percutaneous intervention
KW - pulmonary valve disease
KW - transcatheter valve implantation
UR - http://www.scopus.com/inward/record.url?scp=85044265839&partnerID=8YFLogxK
U2 - 10.1002/ccd.27237
DO - 10.1002/ccd.27237
M3 - Article
C2 - 29024339
AN - SCOPUS:85044265839
SN - 1522-1946
VL - 91
SP - 81
EP - 85
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 1
ER -