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SAPIEN valve for percutaneous transcatheter pulmonary valve replacement without “pre‐stenting”: A multi‐institutional experience
Author(s) -
Morgan Gareth J.,
Sadeghi Soraya,
Salem Moris M.,
Wilson Neil,
Kay Joseph,
Rothman Abraham,
Galindo Alvaro,
Martin Mary Hunt,
Gray Robert,
Ross Michael,
Aboulhosn Jamil A.,
Levi Daniel Steven
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27932
Subject(s) - medicine , percutaneous , valve replacement , cardiac catheterization , cardiology , surgery , stenosis
Objectives To describe a multicenter experience of percutaneous transcatheter pulmonary valve replacement (TPVR) using the Edwards SAPIEN S3 valve without the use of a prior stent (“pre‐stenting”). Background The SAPIEN S3 and XT valves have durable cobalt–chromium stent frames which may allow for TPVR in large diameter dysfunctional right ventricular outflow tracts (RVOTs) without pre‐stenting the landing zone. Methods A retrospective review was performed of all patients with Congenital Heart Disease and dysfunctional RVOT who underwent TPVR using the SAPIEN valve without the use of a pre‐stent. Imaging data, procedural elements, and clinical follow‐up data were collected to evaluate short and intermediate‐term results. Results Fifty‐seven patients underwent percutaneous placement of the SAPIEN valve in the pulmonary position without the use of pre‐stenting. The anatomical substrate varied: native RVOTs ( n = 41), conduits ( n = 10), and bioprosthetic valves ( n = 6). There were no cases in which the valve could not be implanted and no cases of valve embolization or misplacement. On follow‐up (range 1 month to 2.2 years, median 5.3 months), no patients had significant obstruction or regurgitation around the valve. There were no frame fractures. There were no procedural deaths. Major complications included severe aortic compression ( n = 1) requiring surgical explantation and tricuspid valve injury requiring surgical intervention ( n = 2). Conclusions This limited multi‐institutional experience demonstrates that the SAPIEN valve can be used for TPVR without the use of a pre‐stent without medium‐term risk of frame fracture, paravalvar leak, or embolization. Longer term follow‐up is required to fully assess this method.