OP-151 [AJC » PI for SHD - Transcatheter pulmonary valve replacement] Discharge Disposition of Older Patients Undergoing Trans-catheter Aortic Valve Replacement and its Impact on Long Term Outcomes. A Propensity Scoring Matched Analysis

2017 ◽  
Vol 119 (8) ◽  
pp. e11
Author(s):  
Alexis Kofi Okoh ◽  
Dhaval Chauhan ◽  
Nathan Kang ◽  
Nick Haik ◽  
Chunguang Chen ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Older Patients ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Long Term Outcomes ◽  
Propensity Scoring ◽  
Discharge Disposition ◽  
Transcatheter Pulmonary Valve Replacement

Transcatheter Pulmonary Valve Replacement in Patients With Congenital Heart Disease

2018 ◽  
Vol 38 (1) ◽  
pp. 30-36
Author(s):  
Shantelle Bartra
Keyword(s):  
Valve Replacement ◽  
Pulmonary Valve ◽  
Insertion Site ◽  
Pulmonary Valve Replacement ◽  
Long Term Outcomes ◽  
Transcatheter Pulmonary Valve Replacement ◽  
Feasible Alternative ◽  
Short And Long Term ◽  
Infection Monitoring

Transcatheter pulmonary valve replacement is now a feasible alternative to surgical pulmonary valve replacement in children and adults with dysfunctional right ventricular outflow conduits. Currently, 2 types of valves can be used for this application. This article provides an overview of the procedure and how it is performed, indications and contraindications for transcatheter pulmonary valve replacement, and short- and long-term outcomes. Nursing considerations mainly focus on educating patients, preventing bleeding and infection, monitoring renal function, and preventing injury to the catheter insertion site. This article enhances the knowledge of nurses working in cardiac catheterization laboratories and post-procedure recovery and cardiac units so that the nurses can anticipate interventions and understand the management of patients who have transcatheter pulmonary valve replacement.

Transcatheter pulmonary valve insertion: when, how, and why

2012 ◽  
Vol 22 (6) ◽  
pp. 696-701 ◽  
Author(s):  
Jeremy M. Ringewald ◽  
Elsa J. Suh
Keyword(s):  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Percutaneous Approach ◽  
Transcatheter Pulmonary Valve Replacement ◽  
Late Morbidity ◽  
Complementary Strategy ◽  
Term Management

AbstractTranscatheter 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.

Pulmonary Allograft Versus Medtronic Freestyle Valve in Surgical Pulmonary Valve Replacement for Adults Following Correction of Tetralogy of Fallot or Its Variants

2019 ◽  
Vol 10 (5) ◽  
pp. 543-551 ◽  
Author(s):  
Pasangi Madhuka Wijayarathne ◽  
Peter Skillington ◽  
Samuel Menahem ◽  
Amalan Thuraisingam ◽  
Marco Larobina ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Surgical Repair ◽  
Pulmonary Valve ◽  
Pulmonary Stenosis ◽  
Pulmonary Valve Replacement ◽  
Long Term Outcomes ◽  
Significant Difference

Background: Following corrective surgery in infancy/childhood for tetralogy of Fallot (TOF) or its variants, patients may eventually require pulmonary valve replacement (PVR). Debate remains over which valve is best. We compared outcomes of the Medtronic Freestyle valve with that of the pulmonary allograft valve following PVR. Methods: A retrospective study was undertaken from a single surgical practice of adult patients undergoing elective PVR between April 1993 and March 2017. The choice of valve was at the surgeon’s discretion. There was a trend toward the almost exclusive use of the more readily available Medtronic Freestyle valve since 2008. Results: One hundred fifty consecutive patients undergoing 152 elective PVRs were reviewed. Their mean age was 33.8 years. Ninety-four patients had a Medtronic Freestyle valve, while 58 had a pulmonary allograft valve. There were no operative or 30-day mortality. The freedom from reintervention at 5 and 10 years was 98% and 98% for the pulmonary allograft and 99% and 89% for the Medtronic Freestyle. There was no significant difference in the rate of reintervention, though this was colored by higher pulmonary gradients across the Medtronic Freestyle despite its shorter follow-up. Conclusions: Pulmonary valve replacement following previous surgical repair of TOF or its variants was found to be safe with no significant differences in mortality or reintervention between either valve. Although the Medtronic Freestyle valve had a greater tendency toward pulmonary stenosis, additional follow-up is needed to further document its long-term outcomes.

Valve type and long-term outcomes after aortic valve replacement in older patients

Heart ◽  
2008 ◽  
Vol 94 (9) ◽  
pp. 1181-1188 ◽  
Author(s):  
E B Schelbert ◽  
M S Vaughan-Sarrazin ◽  
K F Welke ◽  
G E Rosenthal
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Older Patients ◽  
Long Term Outcomes

The Ross Procedure in Adults: Long-Term Results of Homografts and Stentless Xenografts for Pulmonary Valve Replacement

2016 ◽  
Vol 65 (08) ◽  
pp. 656-661 ◽  
Author(s):  
Benjamin Claus ◽  
Nadine Woythal ◽  
Simon Dushe ◽  
Volkmar Falk ◽  
Herko Grubitzsch ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Long Term Results ◽  
Ross Procedure ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival

Background The Ross procedure is an established method to treat aortic valve disease, offering excellent hemodynamic characteristics, growth potential, low risk of thromboembolism and no need for anticoagulation. Limitation of homograft quality and availability led to the use of different stentless xenografts. Long-term outcome and implications are yet to be addressed. Methods Forty five adult patients (mean age 38.8 ± 9.6 years) with aortic valve stenosis and/or insufficiency, who underwent the Ross procedure between 1995 and 2002 were identified for long-term evaluation. Patients younger than 18 years, with previous heart surgery and endocarditis were excluded. Stentless xenografts were used in 22 cases (Group X) and homografts in 23 cases (Group H). After review of the patients' history, morbidity and mortality were analyzed and risk stratification was performed. Results Between groups, baseline characteristics and operative data did not differ significantly. Total follow-up was 621.0 patient-years and 98.8% complete. Overall freedom from reoperation at 15 years was 68.4 ± 10.6% in group X and 85. ±  7.9% in group H (p = 0.09), respectively. Freedom from aortic valve reoperation at 15 years was comparable (83.9 ± 8.5% in group X and 85.3 ± 7.9% in group H, p = 0.61), whereas freedom from pulmonary valve reoperation at 15 years was significantly lower in group X (78.9 ± 9.4% versus 100%, p = 0.02). Long-term survival at 15 years was 79.7 ± 9.3% in group X and 94.4 ± 5.4% in group H (p = 0.07), respectively. Conclusions Stentless xenografts used as pulmonary valve substitute in the Ross procedure led to lower freedom from pulmonary valve reoperation compared with homografts. Additionally, there was a trend to inferior long-term survival with xenografts. Therefore, homografts should remain the preferred option for pulmonary valve replacement in the Ross procedure.

15 years experience with 615 homograft and autograft aortic valve replacements

1980 ◽  
Vol 3 (3) ◽  
pp. 168-172 ◽  
Author(s):  
W.H. Wain ◽  
R. Greco ◽  
A. Ignegeri ◽  
E. Bodnar ◽  
D.N. Ross
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Alternative Methods ◽  
Homograft Valve ◽  
Long Term Performance ◽  
Term Performance

Homograft valve replacement of the diseased aortic valve with a homologous aortic valve inserted in the sub-coronary position was first performed in July 1962 (Ross 1962). The procedure of transferring the patients autologous pulmonary valve to the aortic position has been used since 1967 (Ross 1967). The long term performance of homograft valves has not been regarded as satisfactory in some centres (Cope-land 1977, Anderson & Hancock 1977) whereas others have shown it to be an excellent valve replacement (Barratt-Boyes, 1977, Bodnar et al 1979). The differing experiences may be the results of alternative methods of sterilization, preservation and surgical insertion. This paper presents information on isolated aortic valve replacements with either homograft or autograft valves over a 15 year period.

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