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Implantable pulmonary artery pressure monitoring device in patients with palliated congenital heart disease: Technical considerations and procedural outcomes
Author(s) -
Salavitabar Arash,
Bradley Elisa A.,
Chisolm Joanne L.,
Hickey Jenne,
Boe Brian A.,
Armstrong Aimee K.,
Daniels Curt J.,
Berman Darren P.
Publication year - 2020
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.28528
Subject(s) - medicine , great arteries , pulmonary artery , heart disease , ambulatory , cardiology , ventricle , heart failure , population , hemodynamics , environmental health
Abstract Objective We describe the technical considerations of transcatheter implantation of the CardioMEMS™ HF System (Abbott, Abbott Park, IL) in adult patients with complex palliated congenital heart disease (CHD) and advanced heart failure (HF). Background Ambulatory pulmonary artery (PA) pressure monitoring with implantable hemodynamic monitors (IHMs) has been shown to reduce HF‐related hospital admissions in non‐CHD populations. HF is a common late cardiovascular complication in adult CHD necessitating better understanding of IHM application in this population. Methods We analyzed adults with complex CHD and advanced HF who were referred for CardioMEMS™ device implantation (2015–2018). Feasibility of device implantation, defined by successful device implantation and calibration, and procedural outcomes were evaluated. Results CardioMEMS™ was successfully implanted in all 14 adults (35.5 ± 9.2 years old, 72 ± 12 kg) with complex CHD (single ventricle/Fontan, n = 8 [57%]; d‐transposition of the great arteries/atrial switch, n = 6 [43%]). The device was delivered via femoral venous access in 13 (93%) patients and implanted in the left PA in 12 (86%). A long sheath was used in 8 (57%) patients, including 5/6 with an atrial switch operation. There was one device migration that did not require retrieval. Conclusions Transcatheter implantation of an IHM is feasible in select complex adult CHD patients with advanced HF. Further studies evaluating integration of ambulatory hemodynamics and the impact on clinical care are needed. This technology has the potential to improve medical management of advanced HF in patients with Fontan and atrial switch physiologies and provide new insights into their ambulatory hemodynamics.