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  • Open Access

    ARTICLE

    Monocusp valve placement in children with tetralogy of Fallot undergoing repair with transannular patch: A functioning pulmonary valve does not improve immediate postsurgical outcomes

    Nikki M. Singh1, Rohit S. Loomba2, Todd M. Gudausky1, Michael E. Mitchell3

    Congenital Heart Disease, Vol.13, No.6, pp. 935-943, 2018, DOI:10.1111/chd.12670

    Abstract Introduction: In patients with tetralogy of Fallot (TOF), use of transannular patch (TAP) may be required in order to relieve significant right ventricular outflow tract obstruction, subsequently resulting in pulmonary insufficiency (PI). The monocusp valve has been used to temporarily reduce insufficiency in hopes to improve short and midterm outcomes. The purpose of this study was to assess for potential benefits of the monocusp valve in this subset of patients.
    Design: Between 2005 and 2016, 119 patients with TOF with pulmonary stenosis who underwent repair with TAP were analyzed, 43 (36.1%) had a monocusp valve placed. Immediate outcomes were assessed… More >

  • Open Access

    ARTICLE

    Achieving biventricular circulation in patients with moderate hypoplastic right ventricle in pulmonary atresia intact ventricular septum after transcatheter pulmonary valve perforation

    Robin H.S. Chen1, Adolphus K.T. Chau1, Pak Cheong Chow1, Tak Cheung Yung1, Yiu Fai Cheung1,2, Kin Shing Lun1

    Congenital Heart Disease, Vol.13, No.6, pp. 884-891, 2018, DOI:10.1111/chd.12658

    Abstract Objective: Transcatheter valve perforation for pulmonary atresia intact ventricular septum is the standard of care for patients with mild right ventricular hypoplasia. However, its role in moderate right ventricular hypoplasia has been less well defined. We sought to report the long‐term outcome of patients with moderate hypoplastic right ventricle who had undergone the procedure.
    Design, Settings, and Patients: We performed a retrospective analysis on patients who had undergone transcatheter pulmonary valve perforation from January 1996 to January 2015 at our institution. The procedures would be carried out irrespective of the right ventricular size, as long as there were no absolute… More >

  • Open Access

    ARTICLE

    Bioprosthetic pulmonary valve endocarditis: Incidence, risk factors, and clinical outcomes

    Brian Robichaud1, Garick Hill2, Scott Cohen1,3, Ronald Woods4, Michael Earing1,3, Peter Frommelt1, Salil Ginde1,3

    Congenital Heart Disease, Vol.13, No.5, pp. 734-739, 2018, DOI:10.1111/chd.12639

    Abstract Background: Pulmonary valve replacement (PVR) is a common operation in patients with congenital heart disease (CHD). As survival with CHD improves, infective endo‐ carditis (IE) is a growing complication after PVR. The aim of this study was to assess the incidence, risk factors, and clinical outcomes of IE after surgical PVR in patients with CHD at our institution.
    Methods: Retrospective analysis of all cases of surgical PVR performed at Children’s Hospital of Wisconsin between 1975 and 2016 was performed. All cases of IE after PVR were identified and clinical and imaging data were obtained by review of medical records.
    Results:More >

  • Open Access

    ARTICLE

    Right ventricular contractile reserve in tetralogy of Fallot patients with pulmonary regurgitation

    Clotilde Kingsley1, Saad Ahmad2, John Pappachan1, Sujata Khambekar1, Thomas Smith1, Diane Gardiner1, James Shambrook1, Shankar Baskar3, Ryan Moore3, Gruschen Veldtman3

    Congenital Heart Disease, Vol.13, No.2, pp. 288-294, 2018, DOI:10.1111/chd.12569

    Abstract Background: The right ventricular (RV) contractile reserve is a measure of the dynamic function of the RV and is a sensitive indicator of volume load. This can be measured noninvasively using the tricuspid annular plane systolic excursion (TAPSE) during exercise. We studied the RV contractile reserve of patients after tetralogy of Fallot (TOF) repair with varying degree of RV dilation and pulmonary regurgitation (PR), and compared them to a control group.
    Methods: Twenty-six patients who had undergone TOF repair (mean age 29 ± 10 years) were identified and stratified into three group based on the presence and severity of RV… More >

  • Open Access

    ARTICLE

    Comparison of valvar and right ventricular function following transcatheter and surgical pulmonary valve replacement

    Wendy F. Li1, Heidi Pollard2, Mohsen Karimi3, Jeremy D. Asnes1, William E. Hellenbrand1, Veronika Shabanova4, Constance G. Weismann1,5

    Congenital Heart Disease, Vol.13, No.1, pp. 140-146, 2018, DOI:10.1111/chd.12544

    Abstract Objective: Trans-catheter (TC) pulmonary valve replacement (PVR) has become common practice for patients with right ventricular outflow tract obstruction (RVOTO) and/or pulmonic insufficiency (PI). Our aim was to compare PVR and right ventricular (RV) function of patients who received TC vs surgical PVR.
    Design: Retrospective review of echocardiograms obtained at three time points: before, immediately after PVR, and most recent.
    Patients: Sixty-two patients (median age 19 years, median follow-up 25 months) following TC (N = 32) or surgical (N = 30) PVR at Yale-New Haven Hospital were included.
    Outcome Measures: Pulmonary valve and right ventricular function before, immediately after, and… More >

  • Open Access

    ARTICLE

    Long‐term outcomes up to 25 years following balloon pulmonary valvuloplasty: A multicenter study

    Rachel L. Hansen1,2, Iman Naimi3, Hongyue Wang1, Nader Atallah3,4, Frank Smith3,4, Craig Byrum3,4, Daniel Kveselis3,4, Glenn Leonard1,5, Rajiv Devanagondi1, Matthew Egan3,4

    Congenital Heart Disease, Vol.14, No.6, pp. 1037-1045, 2019, DOI:10.1111/chd.12788

    Abstract Objective: Evaluate long‐term outcomes following balloon pulmonary valvuloplasty (BPV) for pulmonary stenosis (PS).
    Background: Long‐term data following BPV is limited to small, single center studies.
    Methods: BPV from April 12, 1985 to January 7, 2015 from three centers were included. Outcomes studied were ≥ moderate PI by echocardiogram and residual PS ≥ 40 mm Hg. Risk factors for ≥ moderate PI, residual PS, and repeat intervention were assessed by univariate and multivariate analysis.
    Results: Among 254 patients, mean age at BPV was 3.8 years (range 1 day‐67 years), initial PS catheter gradient was 56 mm Hg (IQR 40‐70), 19% had… More >

  • Open Access

    ARTICLE

    Postoperative and short‐term atrial tachyarrhythmia burdens after transcatheter vs surgical pulmonary valve replacement among congenital heart disease patients

    Subeer K. Wadia1, Gentian Lluri1, Jamil A. Aboulhosn1, Hillel Laks2, Reshma M. Biniwale2, Glen S. Van Arsdell2, Daniel S. Levi3, Morris M. Salem3, Kevin M. Shannon1,3, Jeremy P. Moore1,3

    Congenital Heart Disease, Vol.14, No.5, pp. 838-845, 2019, DOI:10.1111/chd.12818

    Abstract Objective: We examined the atrial tachyarrhythmia (AT) burden among patients with congenital heart disease (CHD) following transcatheter (TC‐) or surgical (S‐) pulmo‐ nary valve replacement (PVR).
    Design/Setting: This was a retrospective observational study of patients who under‐ went PVR from 2010 to 2016 at UCLA Medical Center.
    Patients: Patients of all ages who had prior surgical repair for CHD were included. Patients with a history of congenitally corrected transposition of the great arteries, underwent a hybrid PVR procedure, or had permanent atrial fibrillation (AF) without a concomitant ablation were excluded.
    Outcome Measures: The primary outcome was a time‐to‐event analysis of… More >

  • Open Access

    ARTICLE

    Perforation of the atretic pulmonary valve using chronic total occlusion (CTO) wire and coronary microcatheter

    Bruno Lefort1,2, Christophe Saint‐Etienne1, Nathalie Soulé1, Iris Ma1, Fanny Dion1, Alain Chantepie1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 814-818, 2019, DOI:10.1111/chd.12812

    Abstract Background and objective: Chronic total occlusion (CTO) guidewire have been recently reported as an alternative to radiofrequency for perforating atretic pulmonary valve. Since procedure failures or perforation of the right ventricle still occurred with CTO, we tried to enhance the stability, steering, and pushability of the wire using a microcatheter in order to improve the safety and efficacy of the procedure.
    Methods: We performed pulmonary valve perforation with CTO guidewire and microcatheter in five consecutive newborns with pulmonary atresia with intact ventricular septum (PA‐IVS) under fluoroscopic and echocardiographic control.
    Results: The valve was easily perforated at the first attempt for… More >

  • Open Access

    ARTICLE

    Leaflet morphology classification of the Melody Transcatheter Pulmonary Valve

    Brian A. Boe, Sharon L. Cheatham, Aimee K. Armstrong, Darren P. Berman, Joanne L. Chisolm, John P. Cheatham

    Congenital Heart Disease, Vol.14, No.2, pp. 297-304, 2019, DOI:10.1111/chd.12728

    Abstract Objective: We sought to describe the leaflet morphology variation in the Melody Transcatheter Pulmonary Valve (TPV) and evaluate associated outcomes. The Melody TPV is constructed from harvested bovine jugular venous valves which have been rigorously tested. Natural anatomic leaflet variations are seen in the Melody TPV but have not been evaluated.
    Design: A Melody TPV leaflet morphology classification system was devised after reviewing a subset of photographed and implanted TPVs. All images were blindly re‐ viewed by implanters and classified. Midterm hemodynamic outcomes and complica‐ tions of the Melody TPVs were compared by leaflet morphology.
    Results: Photographed Melody TPVs implanted… More >

  • Open Access

    ARTICLE

    Prevalence of Noonan spectrum disorders in a pediatric population with valvar pulmonary stenosis

    Kailyn Anderson1, James Cnota2,3, Jeanne James4,5, Erin M. Miller2,3, Ashley Parrott3, Valentina Pilipenko1,2, Kathryn Nicole Weaver1,2, Amy Shikany3

    Congenital Heart Disease, Vol.14, No.2, pp. 264-273, 2019, DOI:10.1111/chd.12721

    Abstract Objective: To evaluate the prevalence of Noonan spectrum disorders (NSD) in a pediatric population with valvar pulmonary stenosis (vPS) and identify the clinical characteristics that differentiate those with NSD from those without NSD.
    Design: A retrospective chart review of 204 patients diagnosed with vPS between 9/1/2012 and 12/1/2016 at a pediatric medical center was performed. The quantitative features of vPS, genetic diagnosis information, and phenotypic characteristics of Noonan syndrome were collected. Chi‐square test, Fisher’s exact test, t test, Wilcoxon rank‐sum test, and ANOVA were used for comparisons among the groups. Logistic regression was used to test for the association between… More >

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