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Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series

Introduction: A substantial proportion of patients with adult congenital heart disease (ACHD) suffer from worsening valvular dysfunction in adulthood. Transcatheter valve interventions can offer a therapeutic alternative to surgery for those at high surgical risk. There is emerging but limited data...

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Autores principales: Schamroth Pravda, Nili, Vaknin Assa, Hana, Sondergaard, Lars, Bajoras, Vilhelmas, Sievert, Horst, Piayda, Kerstin, Levi, Amos, Witberg, Guy, Shapira, Yaron, Hamdan, Ashraf, Perl, Leor, Vig, Shahar, Blieden, Leonard, Kornowski, Ran, Hirsch, Rafael, Codner, Pablo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864755/
https://www.ncbi.nlm.nih.gov/pubmed/36675450
http://dx.doi.org/10.3390/jcm12020521
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author Schamroth Pravda, Nili
Vaknin Assa, Hana
Sondergaard, Lars
Bajoras, Vilhelmas
Sievert, Horst
Piayda, Kerstin
Levi, Amos
Witberg, Guy
Shapira, Yaron
Hamdan, Ashraf
Perl, Leor
Vig, Shahar
Blieden, Leonard
Kornowski, Ran
Hirsch, Rafael
Codner, Pablo
author_facet Schamroth Pravda, Nili
Vaknin Assa, Hana
Sondergaard, Lars
Bajoras, Vilhelmas
Sievert, Horst
Piayda, Kerstin
Levi, Amos
Witberg, Guy
Shapira, Yaron
Hamdan, Ashraf
Perl, Leor
Vig, Shahar
Blieden, Leonard
Kornowski, Ran
Hirsch, Rafael
Codner, Pablo
author_sort Schamroth Pravda, Nili
collection PubMed
description Introduction: A substantial proportion of patients with adult congenital heart disease (ACHD) suffer from worsening valvular dysfunction in adulthood. Transcatheter valve interventions can offer a therapeutic alternative to surgery for those at high surgical risk. There is emerging but limited data on transcatheter interventions for atrioventricular (AV) valve dysfunction in patients with ACHD. Methods: We compiled an international collaborative multi-center registry focusing on adult patients with congenital heart disease undergoing transcatheter AV valve interventions (repair or replacement). Included were patients from three international centers who underwent procedures between 2016 and 2022. Demographic, clinical, and procedural data were compiled. Results: Nine patients with ACHD underwent AV valve interventions. The median age was 48 years (IQR (37; 56), 55% women). At baseline, seven patients (78%) were in NYHA functional class III and two (22%) were in NYHA functional class II. The diagnosis of ACHD varied. Three valve interventions were performed on the subpulmonary AV valve and six on the systemic AV valve. The primary valvular pathology was regurgitation (six patients, 78%). Five procedures were valve-in-valve interventions, and four procedures were transcatheter edge-to-edge repair procedures. There were no major complications or peri-procedural complications or peri-procedural mortality. One patient developed a suspected non-obstructive thrombus on the valve that was medically treated. One patient did not improve clinically following the procedure and underwent a heart transplant, one patient died 6 months following the procedure due to a cardiovascular implantable electronic device infection. At one year, six patients were in NYHA functional class I, and one patient was in NYHA functional class III. In conclusion, transcatheter AV heart valve interventions are feasible and safe procedures in carefully selected ACHD patients. These procedures can offer an effective treatment option in these younger patients with high surgical risk.
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spelling pubmed-98647552023-01-22 Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series Schamroth Pravda, Nili Vaknin Assa, Hana Sondergaard, Lars Bajoras, Vilhelmas Sievert, Horst Piayda, Kerstin Levi, Amos Witberg, Guy Shapira, Yaron Hamdan, Ashraf Perl, Leor Vig, Shahar Blieden, Leonard Kornowski, Ran Hirsch, Rafael Codner, Pablo J Clin Med Article Introduction: A substantial proportion of patients with adult congenital heart disease (ACHD) suffer from worsening valvular dysfunction in adulthood. Transcatheter valve interventions can offer a therapeutic alternative to surgery for those at high surgical risk. There is emerging but limited data on transcatheter interventions for atrioventricular (AV) valve dysfunction in patients with ACHD. Methods: We compiled an international collaborative multi-center registry focusing on adult patients with congenital heart disease undergoing transcatheter AV valve interventions (repair or replacement). Included were patients from three international centers who underwent procedures between 2016 and 2022. Demographic, clinical, and procedural data were compiled. Results: Nine patients with ACHD underwent AV valve interventions. The median age was 48 years (IQR (37; 56), 55% women). At baseline, seven patients (78%) were in NYHA functional class III and two (22%) were in NYHA functional class II. The diagnosis of ACHD varied. Three valve interventions were performed on the subpulmonary AV valve and six on the systemic AV valve. The primary valvular pathology was regurgitation (six patients, 78%). Five procedures were valve-in-valve interventions, and four procedures were transcatheter edge-to-edge repair procedures. There were no major complications or peri-procedural complications or peri-procedural mortality. One patient developed a suspected non-obstructive thrombus on the valve that was medically treated. One patient did not improve clinically following the procedure and underwent a heart transplant, one patient died 6 months following the procedure due to a cardiovascular implantable electronic device infection. At one year, six patients were in NYHA functional class I, and one patient was in NYHA functional class III. In conclusion, transcatheter AV heart valve interventions are feasible and safe procedures in carefully selected ACHD patients. These procedures can offer an effective treatment option in these younger patients with high surgical risk. MDPI 2023-01-09 /pmc/articles/PMC9864755/ /pubmed/36675450 http://dx.doi.org/10.3390/jcm12020521 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
Schamroth Pravda, Nili
Vaknin Assa, Hana
Sondergaard, Lars
Bajoras, Vilhelmas
Sievert, Horst
Piayda, Kerstin
Levi, Amos
Witberg, Guy
Shapira, Yaron
Hamdan, Ashraf
Perl, Leor
Vig, Shahar
Blieden, Leonard
Kornowski, Ran
Hirsch, Rafael
Codner, Pablo
Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series
title Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series
title_full Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series
title_fullStr Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series
title_full_unstemmed Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series
title_short Transcatheter Interventions for Atrioventricular Dysfunction in Patients with Adult Congenital Heart Disease: An International Case Series
title_sort transcatheter interventions for atrioventricular dysfunction in patients with adult congenital heart disease: an international case series
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9864755/
https://www.ncbi.nlm.nih.gov/pubmed/36675450
http://dx.doi.org/10.3390/jcm12020521
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