Procedural technique for hybrid pulmonary valve replacement in infants and small children

Author:

Breatnach Colm R1,McGuinness Jonathan2,Ng Li Yen1ORCID,Franklin Orla1,Redmond Mark2,Nölke Lars2,McMahon Colin1,Oslizlok Paul1,Walsh Kevin1,Kenny Damien1

Affiliation:

1. Department of Cardiology, Children’s Health Ireland at Crumlin, Dublin, Ireland

2. Department of Cardiothoracic Surgery, Children’s Health Ireland at Crumlin, Dublin, Ireland

Abstract

Abstract OBJECTIVES Hybrid approach to pulmonary valve replacement (PVR) in the paediatric population has been reported, although data in infants and small children are limited. Several strategies are now possible. The aim of this study is to review our hybrid PVR strategy in a complex patient cohort, outlining a variety of approaches employed in our centre. METHODS We performed a retrospective review of infants and small children who underwent hybrid PVR between May 2017 and April 2019 in a single tertiary cardiology centre. Medical records were reviewed to ascertain demographic, clinical and outcome data. RESULTS Ten patients with a median (interquartile range) age of 1.5 years (1.1–1.9) and weight of 8.8 kg (8–10.6) were managed with hybrid pulmonary valve insertion. Eight patients had perventricular approach (4 sternotomy and 4 subxiphoid) and 2 patients had surgically sutured valve. Six patients underwent cardiopulmonary bypass for associated lesions. Three had insertion of the valve into conduits and 7 were deployed into native right ventricular outflow tracts. The pulmonary valve was successfully inserted in all 10 patients with no mortality. Postprocedural complications included paravalvar leak in 2 patients, suspected endocarditis in 1 patient who developed early valve regurgitation and wound infection in 1 patient. CONCLUSIONS Several approaches to hybrid PVR may be employed in small children with a high success rate. Follow-up studies are required to evaluate longer term durability of these approaches compared to standard surgical replacement.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery

Cited by 5 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Ten Years of Percutaneous Pulmonary Valve Implantation in Australia and New Zealand;Heart, Lung and Circulation;2022-12

2. Hybrid approach for harmony transcatheter pulmonary valve replacement;Catheterization and Cardiovascular Interventions;2022-11-26

3. Transcatheter Pulmonary Valve Replacement: A Review of Current Valve Technologies;Journal of the Society for Cardiovascular Angiography & Interventions;2022-11

4. Single‐Center Experience of Hybrid Pulmonary Valve Replacement Using Left Anterior Thoracotomy With Pulmonary Artery Plication in Patients With Large Right Ventricular Outflow Tract;Journal of the American Heart Association;2022-07-19

5. We can, but should we?;European Journal of Cardio-Thoracic Surgery;2020-12-14

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