RESUMO
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.
Assuntos
Endocardite Bacteriana , Endocardite , Cardiopatias Congênitas , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Insuficiência da Valva Pulmonar , Valva Pulmonar , Trombose , Adulto , Humanos , Cateterismo Cardíaco/efeitos adversos , Endocardite/epidemiologia , Endocardite Bacteriana/complicações , Cardiopatias Congênitas/complicações , Próteses Valvulares Cardíacas/efeitos adversos , Implante de Prótese de Valva Cardíaca/efeitos adversos , Desenho de Prótese , Valva Pulmonar/cirurgia , Insuficiência da Valva Pulmonar/epidemiologia , Insuficiência da Valva Pulmonar/cirurgia , Sistema de Registros , Estudos Retrospectivos , Trombose/etiologia , Resultado do TratamentoRESUMO
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.
Assuntos
Doença da Artéria Coronariana , Anomalias dos Vasos Coronários , Fístula , Transplante de Coração , Criança , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/etiologia , Anomalias dos Vasos Coronários/diagnóstico por imagem , Transplante de Coração/efeitos adversos , HumanosRESUMO
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.
Assuntos
Bioprótese , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Insuficiência da Valva Tricúspide , Bioprótese/efeitos adversos , Cateterismo Cardíaco , Pré-Escolar , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Desenho de Prótese , Falha de Prótese , Resultado do Tratamento , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia , Insuficiência da Valva Tricúspide/diagnóstico , Insuficiência da Valva Tricúspide/cirurgiaRESUMO
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.
Assuntos
Comunicação Interatrial , Dispositivo para Oclusão Septal , Adolescente , Cateterismo Cardíaco/efeitos adversos , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Feminino , Comunicação Interatrial/diagnóstico , Comunicação Interatrial/cirurgia , Humanos , Dispositivo para Oclusão Septal/efeitos adversos , Resultado do TratamentoRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Canal Arterial/cirurgia , Cardiopatias Congênitas/cirurgia , Stents , Coração Auxiliar , Estudos Retrospectivos , Resultado do TratamentoRESUMO
No disponible
Assuntos
Humanos , Masculino , Recém-Nascido , Lactente , Cuidados Paliativos/métodos , Síndrome de Cimitarra/terapia , Síndrome de Cimitarra/diagnósticoRESUMO
No disponible
Assuntos
Humanos , Masculino , Recém-Nascido , Arteriopatias Oclusivas/cirurgia , Estenose de Artéria Pulmonar/cirurgia , Stents , Arteriopatias Oclusivas/diagnóstico , Atresia Pulmonar/complicações , Cateterismo Cardíaco/métodosRESUMO
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.
Assuntos
Canal Arterial/cirurgia , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Falha de Prótese , Stents/efeitos adversos , Angiografia , Procedimentos Cirúrgicos Cardíacos/instrumentação , Humanos , Recém-Nascido , Masculino , Artéria Pulmonar/cirurgia , Resultado do TratamentoRESUMO
No disponible
Assuntos
Humanos , Feminino , Criança , Permeabilidade do Canal Arterial/cirurgia , Comunicação Interatrial/cirurgia , Hipersensibilidade/imunologia , Níquel/efeitos adversos , Níquel/imunologiaRESUMO
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.
Assuntos
Doença da Artéria Coronariana/etiologia , Everolimo/efeitos adversos , Fístula/etiologia , Imunossupressores/efeitos adversos , Pré-Escolar , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Fístula/diagnóstico por imagem , Transplante de Coração , Humanos , MasculinoRESUMO
"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.
