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Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort

Introduction: Increasing survival of adult congenital heart disease (ACHD) patients comes at the price of a range of late complications—arrhythmias, heart failure, and valvular dysfunction. Transcatheter valve interventions have become a legitimate alternative to conventional surgical treatment in s...

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Autores principales: El Bouziani, Abdelhak, Witte, Lars S., Bouma, Berto J., Jongbloed, Monique R. M., Robbers-Visser, Daniëlle, Straver, Bart, Beijk, Marcel A. M., Kiès, Philippine, Koolbergen, David R., van der Kley, Frank, Schalij, Martin J., de Winter, Robbert J., Egorova, Anastasia D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381460/
https://www.ncbi.nlm.nih.gov/pubmed/37510913
http://dx.doi.org/10.3390/jcm12144798
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author El Bouziani, Abdelhak
Witte, Lars S.
Bouma, Berto J.
Jongbloed, Monique R. M.
Robbers-Visser, Daniëlle
Straver, Bart
Beijk, Marcel A. M.
Kiès, Philippine
Koolbergen, David R.
van der Kley, Frank
Schalij, Martin J.
de Winter, Robbert J.
Egorova, Anastasia D.
author_facet El Bouziani, Abdelhak
Witte, Lars S.
Bouma, Berto J.
Jongbloed, Monique R. M.
Robbers-Visser, Daniëlle
Straver, Bart
Beijk, Marcel A. M.
Kiès, Philippine
Koolbergen, David R.
van der Kley, Frank
Schalij, Martin J.
de Winter, Robbert J.
Egorova, Anastasia D.
author_sort El Bouziani, Abdelhak
collection PubMed
description Introduction: Increasing survival of adult congenital heart disease (ACHD) patients comes at the price of a range of late complications—arrhythmias, heart failure, and valvular dysfunction. Transcatheter valve interventions have become a legitimate alternative to conventional surgical treatment in selected acquired heart disease patients. However, literature on technical aspects, hemodynamic effects, and clinical outcomes of percutaneous atrioventricular (AV) valve interventions in ACHD patients is scarce. Method: This is a descriptive cohort from CAHAL (Center of Congenital Heart Disease Amsterdam-Leiden). ACHD patients with severe AV valve regurgitation who underwent a transcatheter intervention in the period 2020–2022 were included. Demographic, clinical, procedural, and follow-up data were collected from patient records. Results: Five ACHD patients with severe or torrential AV valve regurgitation are described. Two patients underwent a transcatheter edge-to-edge repair (TEER), one patient underwent a valve-in-valve procedure, one patient received a Cardioband system, and one patient received both a Cardioband system and TEER. No periprocedural complications occurred. Post-procedural AV valve regurgitation as well as NYHA functional class improved in all patients. The median post-procedural NYHA functional class improved from 3.0 (IQR [2.5–4.0]) to 2.0 (IQR [1.5–2.5]). One patient died 9 months after the procedure due to advanced heart failure with multiorgan dysfunction. Conclusion: Transcatheter valve repair is feasible and safe in selected complex ACHD patients. A dedicated heart team is essential for determining an individualized treatment strategy as well as pre- and periprocedural imaging to address the underlying mechanism(s) of AV regurgitation and guide the transcatheter intervention. Long-term follow-up is essential to evaluate the clinical outcomes of transcatheter AV valve repair in ACHD patients.
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spelling pubmed-103814602023-07-29 Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort El Bouziani, Abdelhak Witte, Lars S. Bouma, Berto J. Jongbloed, Monique R. M. Robbers-Visser, Daniëlle Straver, Bart Beijk, Marcel A. M. Kiès, Philippine Koolbergen, David R. van der Kley, Frank Schalij, Martin J. de Winter, Robbert J. Egorova, Anastasia D. J Clin Med Article Introduction: Increasing survival of adult congenital heart disease (ACHD) patients comes at the price of a range of late complications—arrhythmias, heart failure, and valvular dysfunction. Transcatheter valve interventions have become a legitimate alternative to conventional surgical treatment in selected acquired heart disease patients. However, literature on technical aspects, hemodynamic effects, and clinical outcomes of percutaneous atrioventricular (AV) valve interventions in ACHD patients is scarce. Method: This is a descriptive cohort from CAHAL (Center of Congenital Heart Disease Amsterdam-Leiden). ACHD patients with severe AV valve regurgitation who underwent a transcatheter intervention in the period 2020–2022 were included. Demographic, clinical, procedural, and follow-up data were collected from patient records. Results: Five ACHD patients with severe or torrential AV valve regurgitation are described. Two patients underwent a transcatheter edge-to-edge repair (TEER), one patient underwent a valve-in-valve procedure, one patient received a Cardioband system, and one patient received both a Cardioband system and TEER. No periprocedural complications occurred. Post-procedural AV valve regurgitation as well as NYHA functional class improved in all patients. The median post-procedural NYHA functional class improved from 3.0 (IQR [2.5–4.0]) to 2.0 (IQR [1.5–2.5]). One patient died 9 months after the procedure due to advanced heart failure with multiorgan dysfunction. Conclusion: Transcatheter valve repair is feasible and safe in selected complex ACHD patients. A dedicated heart team is essential for determining an individualized treatment strategy as well as pre- and periprocedural imaging to address the underlying mechanism(s) of AV regurgitation and guide the transcatheter intervention. Long-term follow-up is essential to evaluate the clinical outcomes of transcatheter AV valve repair in ACHD patients. MDPI 2023-07-20 /pmc/articles/PMC10381460/ /pubmed/37510913 http://dx.doi.org/10.3390/jcm12144798 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
El Bouziani, Abdelhak
Witte, Lars S.
Bouma, Berto J.
Jongbloed, Monique R. M.
Robbers-Visser, Daniëlle
Straver, Bart
Beijk, Marcel A. M.
Kiès, Philippine
Koolbergen, David R.
van der Kley, Frank
Schalij, Martin J.
de Winter, Robbert J.
Egorova, Anastasia D.
Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort
title Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort
title_full Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort
title_fullStr Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort
title_full_unstemmed Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort
title_short Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort
title_sort catheter-based techniques for addressing atrioventricular valve regurgitation in adult congenital heart disease patients: a descriptive cohort
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381460/
https://www.ncbi.nlm.nih.gov/pubmed/37510913
http://dx.doi.org/10.3390/jcm12144798
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