RESUMEN
BACKGROUND AND AIMS: Transcatheter pulmonary valve implantation (TPVI) is indicated to treat right-ventricular outflow tract (RVOT) dysfunction related to congenital heart disease (CHD). Outcomes of TPVI with the SAPIEN 3 valve that are insufficiently documented were investigated in the EUROPULMS3 registry of SAPIEN 3-TPVI. METHODS: Patient-related, procedural, and follow-up outcome data were retrospectively assessed in this observational cohort from 35 centres in 15 countries. RESULTS: Data for 840 consecutive patients treated in 2014-2021 at a median age of 29.2 (19.0-41.6) years were obtained. The most common diagnosis was conotruncal defect (70.5%), with a native or patched RVOT in 50.7% of all patients. Valve sizes were 20, 23, 26, and 29â mm in 0.4%, 25.5%, 32.1%, and 42.0% of patients, respectively. Valve implantation was successful in 98.5% [95% confidence interval (CI), 97.4%-99.2%] of patients. Median follow-up was 20.3 (7.1-38.4) months. Eight patients experienced infective endocarditis; 11 required pulmonary valve replacement, with a lower incidence for larger valves (P = .009), and four experienced pulmonary valve thrombosis, including one who died and three who recovered with anticoagulation. Cumulative incidences (95%CI) 1, 3, and 6 years after TPVI were as follows: infective endocarditis, 0.5% (0.0%-1.0%), 0.9% (0.2%-1.6%), and 3.8% (0.0%-8.4%); pulmonary valve replacement, 0.4% (0.0%-0.8%), 1.3% (0.2%-2.4%), and 8.0% (1.2%-14.8%); and pulmonary valve thrombosis, 0.4% (0.0%-0.9%), 0.7% (0.0%-1.3%), and 0.7% (0.0%-1.3%), respectively. CONCLUSIONS: Outcomes of SAPIEN 3 TPVI were favourable in patients with CHD, half of whom had native or patched RVOTs.
Asunto(s)
Endocarditis Bacteriana , Endocarditis , Cardiopatías Congénitas , Implantación de Prótesis de Válvulas Cardíacas , Prótesis Valvulares Cardíacas , Insuficiencia de la Válvula Pulmonar , Válvula Pulmonar , Trombosis , Adulto , Humanos , Cateterismo Cardíaco/efectos adversos , Endocarditis/epidemiología , Endocarditis Bacteriana/complicaciones , Cardiopatías Congénitas/complicaciones , Prótesis Valvulares Cardíacas/efectos adversos , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Diseño de Prótesis , Válvula Pulmonar/cirugía , Insuficiencia de la Válvula Pulmonar/epidemiología , Insuficiencia de la Válvula Pulmonar/cirugía , Sistema de Registros , Estudios Retrospectivos , Trombosis/etiología , Resultado del TratamientoRESUMEN
Coronary artery fistulas have been described in patients after heart transplantation more often than in the normal population. We reviewed our centre's database between 2008 and 2020. Thirty patients had coronary angiography and 13 showed non-cameral coronary artery fistulas in their first coronary angiography. Distribution, degree and evolution of the fistulas and characteristics of transplant procedure, patient and immunosuppressive treatments were analysed.
Asunto(s)
Enfermedad de la Arteria Coronaria , Anomalías de los Vasos Coronarios , Fístula , Trasplante de Corazón , Niño , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/etiología , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Trasplante de Corazón/efectos adversos , HumanosRESUMEN
A 4-year-old child of 10 kg weight, with four previous sternotomies, presented a severe right heart failure, due to a severe regurgitation of his bioprosthetic tricuspid valve. A percutaneous tricuspid valve in valve procedure with an Edwards S3 valve was offered for compassionate use, and performed, with no complications, and significant clinical condition improvement.
Asunto(s)
Bioprótesis , Implantación de Prótesis de Válvulas Cardíacas , Prótesis Valvulares Cardíacas , Insuficiencia de la Válvula Tricúspide , Bioprótesis/efectos adversos , Cateterismo Cardíaco , Preescolar , Prótesis Valvulares Cardíacas/efectos adversos , Humanos , Diseño de Prótesis , Falla de Prótesis , Resultado del Tratamiento , Válvula Tricúspide/diagnóstico por imagen , Válvula Tricúspide/cirugía , Insuficiencia de la Válvula Tricúspide/diagnóstico , Insuficiencia de la Válvula Tricúspide/cirugíaRESUMEN
Percutaneous closure of atrial septal defect is recognised as a safe and effective procedure, however, in some patients complications may occur. Although chest pain has been sporadically reported, its exact aetiology has been poorly studied. Herein, a 14-year-old female with an atypical and long-lasting chest pain after percutaneous atrial septal defect closure is described.
Asunto(s)
Defectos del Tabique Interatrial , Dispositivo Oclusor Septal , Adolescente , Cateterismo Cardíaco/efectos adversos , Dolor en el Pecho/diagnóstico , Dolor en el Pecho/etiología , Femenino , Defectos del Tabique Interatrial/diagnóstico , Defectos del Tabique Interatrial/cirugía , Humanos , Dispositivo Oclusor Septal/efectos adversos , Resultado del TratamientoRESUMEN
We report an asymptomatic 5-year-old boy with coronary artery fistulas to pulmonary parenchyma and to systemic thoracic arteries, like a "natural bypass", detected during a coronary angiography performed 11 months after his heart transplant. One year later, a new coronary angiography showed no fistula. Some changes to immunosuppressive therapy during this time could be related to this evolution.
Asunto(s)
Enfermedad de la Arteria Coronaria/etiología , Everolimus/efectos adversos , Fístula/etiología , Inmunosupresores/efectos adversos , Preescolar , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Fístula/diagnóstico por imagen , Trasplante de Corazón , Humanos , MasculinoRESUMEN
We implanted two sinus Superflex DS© stents in a systemic non-stenotic arterial duct of a newborn with hypoplastic left heart syndrome. Forty-eight hours later an important collapse of the stent was detected and treated with a balloon expandable stent. Sinus Superflex DS© has been specifically designed for systemic ducts. This complication generates doubts about its radial force in this scenario.
Asunto(s)
Conducto Arterial/cirugía , Síndrome del Corazón Izquierdo Hipoplásico/cirugía , Falla de Prótesis , Stents/efectos adversos , Angiografía , Procedimientos Quirúrgicos Cardíacos/instrumentación , Humanos , Recién Nacido , Masculino , Arteria Pulmonar/cirugía , Resultado del TratamientoRESUMEN
A 29-week-old male foetus was diagnosed by foetal echocardiography with severe hypertrophic cardiomyopathy with systolic dysfunction and generalized oedema, undergoing a Caesarean section at 33 weeks. Mechanical ventilation and milrinone infusion were required during the first week. Systolic function and output parameters improved progressively. Metabolic and infectious screenings were negative. At the follow-up, during the first year of life, hypertrophy regressed, posterior right auricular hypertrophy evolved to a mass with cysts, and left ventricular myocardium developed trabeculations accomplishing non-compaction criteria. Recently, mutations in genes previously implicated in the pathogenesis of hypertrophic cardiomyopathy have been identified in patients with left ventricular non-compaction without hypertrophy. This report suggests that these cardiomyopathies may have a similar genetic origin, and can co-exist in the same patient.
Asunto(s)
Cardiomiopatía Hipertrófica/diagnóstico por imagen , Ecocardiografía , No Compactación Aislada del Miocardio Ventricular/diagnóstico por imagen , Ultrasonografía Prenatal , Cardiomiopatía Hipertrófica/fisiopatología , Cesárea , Progresión de la Enfermedad , Femenino , Humanos , Recién Nacido , No Compactación Aislada del Miocardio Ventricular/fisiopatología , Masculino , EmbarazoRESUMEN
"Persistence of the fifth aortic arch" is a rare congenital cardiovascular anomaly that consists of an abnormal vessel arising from the distal ascending aorta connecting with the systemic or pulmonary circulation. We report a case of a type A interruption of the aortic arch and a coarctation of the fifth aortic arch, which connected the ascending with the descending aorta. No cardiac surgery was required because a covered stent was successfully implanted in the fifth aortic arch when the patient was 4 years old. A chromosome 9 q arm duplication of uncertain significance was also found, an anomaly never described before in this clinical context.
Asunto(s)
Aorta Torácica/diagnóstico por imagen , Coartación Aórtica/terapia , Tratamiento Conservador/métodos , Coartación Aórtica/diagnóstico , Angiografía por Tomografía Computarizada , Ecocardiografía , Humanos , Lactante , MasculinoRESUMEN
Isolated noncompaction of the ventricular myocardium is thought to be caused by arrest of normal embryogenesis of the endocardium and myocardium. Clinical manifestations are highly variable, from no symptoms to congestive heart failure, arrhythmias, and systemic thromboemboli. Both familial and sporadic forms have been described, and mutations of certain genes have been related with this entity. Partial penetration of the disease is reported. We report an asymptomatic infant accomplishing the echocardiographic criteria, and his mother, showing prominent trabeculations and recesses, but not fulfilling all the diagnosis criteria.
Asunto(s)
Cardiomiopatías/genética , Cardiomiopatías/patología , Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/embriología , Preescolar , Endotelio/patología , Ventrículos Cardíacos/embriología , Ventrículos Cardíacos/patología , Humanos , Masculino , Miocardio/patología , UltrasonografíaRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Recién Nacido , Lactante , Cuidados Paliativos/métodos , Síndrome de Cimitarra/terapia , Síndrome de Cimitarra/diagnósticoRESUMEN
No disponible