Introduction of transcatheter edge-to-edge repair in patients with congenital heart disease at a children's hospital.
Catheter Cardiovasc Interv
; 103(2): 326-334, 2024 02.
Article
em En
| MEDLINE
| ID: mdl-38149722
ABSTRACT
BACKGROUND:
Atrioventricular valve regurgitation (AVVR) is a devastating complication in children and young adults with congenital heart disease (CHD), particularly in patients with single ventricle physiology. Transcatheter edge-to-edge repair (TEER) is a rapidly expanding, minimally invasive option for the treatment of AVVR in adults that avoids the morbidity and mortality associated with open heart surgery. However, application of TEER in in CHD and in children is quite novel. We describe the development of a peri-procedural protocol including image-derived pre-intervention simulation, with successful application to four patients.AIMS:
To describe the initial experience using the MitraClip system for TEER of dysfunctional systemic atrioventricular valves in patients with congential heart disease within a pediatric hospital.METHODS:
A standardized screening and planning process was developed using cardiac magnetic resonance imaging, three dimensional echocardiography and both virtual and physical simulation. Procedures were performed using the MitraClip G4 system and patients were clinically followed post-intervention.RESULTS:
A series of four CHD patients with at least severe AVVR were screened for suitability for TEER with the MitraClip system three patients had single ventricle physiology and Fontan palliation, and one had repair of a common atrioventricular canal defect. Each patient had at least severe systemic AVVR and was considered at prohibitively high risk for surgical repair. Each patient underwent a standardized preprocedural screening protocol and image-derived modeling followed by the TEER procedure with successful clip placement at the intended location in all cases.CONCLUSIONS:
The early results of our protocolized efforts to introduce TEER repair of severe AV valve regurgitation with MitraClip into the CHD population within our institution are encouraging. Further investigations of the use of TEER in this challenging population are warranted.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Técnica de Fontan
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Implante de Prótese de Valva Cardíaca
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Cardiopatias Congênitas
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Defeitos dos Septos Cardíacos
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Insuficiência da Valva Mitral
Limite:
Child
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Humans
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos