Edwards SAPIEN Transcatheter Pulmonary Valve Implantation: Results From a French Registry

The aim of this study was to describe and analyze data from patients treated in France with the Edwards SAPIEN transcatheter heart valve in the pulmonary position. The Edwards SAPIEN valve has recently been introduced for percutaneous pulmonary valve implantation (PPVI). From April 2011 to May 2017,...

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Published inJACC. Cardiovascular interventions Vol. 11; no. 19; p. 1909
Main Authors Plessis, Julien, Hascoët, Sébastien, Baruteau, Alban, Godart, François, Le Gloan, Laurianne, Warin Fresse, Karine, Tahhan, Nabil, Riou, Jean-Yves, Guyomarch, Béatrice, Petit, Jérôme, Guérin, Patrice
Format Journal Article
LanguageEnglish
Published United States 08.10.2018
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ISSN1876-7605
1876-7605
DOI10.1016/j.jcin.2018.05.050

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Abstract The aim of this study was to describe and analyze data from patients treated in France with the Edwards SAPIEN transcatheter heart valve in the pulmonary position. The Edwards SAPIEN valve has recently been introduced for percutaneous pulmonary valve implantation (PPVI). From April 2011 to May 2017, 71 patients undergoing PPVI were consecutively included. The median age at PPVI was 26.8 years (range 12.8 to 70.1 years). Primary underlying diagnoses were conotruncal malformations (common arterial trunk, tetralogy of Fallot and variants; n = 45), Ross procedure (n = 18), and other diagnoses (n = 8). PPVI indication was pure stenosis in 33.8% of patients, pure regurgitation in 28.1%, and mixed lesions in 38.1%. PPVI was successfully implemented in 68 patients (95.8%). Pre-stenting of the right ventricular outflow tract was performed in 70 patients (98.6%). Early major complications occurred in 4 subjects (5.6%), including 1 death, 1 coronary compression, and 2 pulmonary valve embolizations. Three of the 4 major complications occurred in the first 15 operated patients. No significant regurgitation was recorded after the procedure. Transpulmonary gradient was significantly reduced from 34.5 to 10.5 mm Hg (p < 0.0001). No patient died during a 1-month follow-up period. At 1-year follow-up, the death rate was 2.9%, and 3 patients had undergone surgical reintervention (44%). Early results with the Edwards SAPIEN valve in the pulmonary position demonstrate an ongoing high rate of procedural success.
AbstractList The aim of this study was to describe and analyze data from patients treated in France with the Edwards SAPIEN transcatheter heart valve in the pulmonary position. The Edwards SAPIEN valve has recently been introduced for percutaneous pulmonary valve implantation (PPVI). From April 2011 to May 2017, 71 patients undergoing PPVI were consecutively included. The median age at PPVI was 26.8 years (range 12.8 to 70.1 years). Primary underlying diagnoses were conotruncal malformations (common arterial trunk, tetralogy of Fallot and variants; n = 45), Ross procedure (n = 18), and other diagnoses (n = 8). PPVI indication was pure stenosis in 33.8% of patients, pure regurgitation in 28.1%, and mixed lesions in 38.1%. PPVI was successfully implemented in 68 patients (95.8%). Pre-stenting of the right ventricular outflow tract was performed in 70 patients (98.6%). Early major complications occurred in 4 subjects (5.6%), including 1 death, 1 coronary compression, and 2 pulmonary valve embolizations. Three of the 4 major complications occurred in the first 15 operated patients. No significant regurgitation was recorded after the procedure. Transpulmonary gradient was significantly reduced from 34.5 to 10.5 mm Hg (p < 0.0001). No patient died during a 1-month follow-up period. At 1-year follow-up, the death rate was 2.9%, and 3 patients had undergone surgical reintervention (44%). Early results with the Edwards SAPIEN valve in the pulmonary position demonstrate an ongoing high rate of procedural success.
The aim of this study was to describe and analyze data from patients treated in France with the Edwards SAPIEN transcatheter heart valve (Edwards Lifesciences LLC, Irvine, California) in the pulmonary position.OBJECTIVESThe aim of this study was to describe and analyze data from patients treated in France with the Edwards SAPIEN transcatheter heart valve (Edwards Lifesciences LLC, Irvine, California) in the pulmonary position.The Edwards SAPIEN valve has recently been introduced for percutaneous pulmonary valve implantation (PPVI).BACKGROUNDThe Edwards SAPIEN valve has recently been introduced for percutaneous pulmonary valve implantation (PPVI).From April 2011 to May 2017, 71 patients undergoing PPVI were consecutively included.METHODSFrom April 2011 to May 2017, 71 patients undergoing PPVI were consecutively included.The median age at PPVI was 26.8 years (range 12.8 to 70.1 years). Primary underlying diagnoses were conotruncal malformations (common arterial trunk, tetralogy of Fallot and variants; n = 45), Ross procedure (n = 18), and other diagnoses (n = 8). PPVI indication was pure stenosis in 33.8% of patients, pure regurgitation in 28.1%, and mixed lesions in 38.1%. PPVI was successfully implemented in 68 patients (95.8%). Pre-stenting of the right ventricular outflow tract was performed in 70 patients (98.6%). Early major complications occurred in 4 subjects (5.6%), including 1 death, 1 coronary compression, and 2 pulmonary valve embolizations. Three of the 4 major complications occurred in the first 15 operated patients. No significant regurgitation was recorded after the procedure. Transpulmonary gradient was significantly reduced from 34.5 to 10.5 mm Hg (p < 0.0001). No patient died during a 1-month follow-up period. At 1-year follow-up, the death rate was 2.9%, and 3 patients had undergone surgical reintervention (44%).RESULTSThe median age at PPVI was 26.8 years (range 12.8 to 70.1 years). Primary underlying diagnoses were conotruncal malformations (common arterial trunk, tetralogy of Fallot and variants; n = 45), Ross procedure (n = 18), and other diagnoses (n = 8). PPVI indication was pure stenosis in 33.8% of patients, pure regurgitation in 28.1%, and mixed lesions in 38.1%. PPVI was successfully implemented in 68 patients (95.8%). Pre-stenting of the right ventricular outflow tract was performed in 70 patients (98.6%). Early major complications occurred in 4 subjects (5.6%), including 1 death, 1 coronary compression, and 2 pulmonary valve embolizations. Three of the 4 major complications occurred in the first 15 operated patients. No significant regurgitation was recorded after the procedure. Transpulmonary gradient was significantly reduced from 34.5 to 10.5 mm Hg (p < 0.0001). No patient died during a 1-month follow-up period. At 1-year follow-up, the death rate was 2.9%, and 3 patients had undergone surgical reintervention (44%).Early results with the Edwards SAPIEN valve in the pulmonary position demonstrate an ongoing high rate of procedural success.CONCLUSIONSEarly results with the Edwards SAPIEN valve in the pulmonary position demonstrate an ongoing high rate of procedural success.
Author Petit, Jérôme
Hascoët, Sébastien
Baruteau, Alban
Guyomarch, Béatrice
Tahhan, Nabil
Guérin, Patrice
Plessis, Julien
Godart, François
Le Gloan, Laurianne
Warin Fresse, Karine
Riou, Jean-Yves
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  surname: Guérin
  fullname: Guérin, Patrice
  organization: Centre Hospitalier Universitaire de Nantes, Institut du Thorax, Fédération des Cardiopathies Congénitales, Service de Cardiologie, Nantes, France
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Issue 19
Keywords congenital heart disease
percutaneous pulmonary valve implantation
pulmonary regurgitation
Edwards SAPIEN pulmonic valve
pulmonary stenosis
Language English
License Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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