Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation.
Adolescent
Adult
Cardiac Catheterization
/ adverse effects
Child
Female
France
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
/ adverse effects
Humans
Male
Middle Aged
Prosthesis Design
Pulmonary Valve
/ diagnostic imaging
Pulmonary Valve Insufficiency
/ diagnostic imaging
Recovery of Function
Retrospective Studies
Stents
Treatment Outcome
Ventricular Outflow Obstruction
/ diagnostic imaging
Young Adult
Endoprothèse
Implantation percutanée de valve pulmonaire
Percutaneous pulmonary valve implantation
Right ventricular outflow tract
Stent
Voie de sortie ventriculaire droite
Journal
Archives of cardiovascular diseases
ISSN: 1875-2128
Titre abrégé: Arch Cardiovasc Dis
Pays: Netherlands
ID NLM: 101465655
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
30
06
2019
revised:
03
12
2019
accepted:
12
12
2019
pubmed:
23
2
2020
medline:
23
6
2020
entrez:
22
2
2020
Statut:
ppublish
Résumé
The indications for percutaneous pulmonary valve implantation (PPVI) have been extended to include large dysfunctional right ventricular outflow tracts (RVOTs). Prestenting of the RVOT is commonly performed before PPVI in order to ensure a stable landing zone. The AndraStent XXL (AndraMed GmbH, Reutlingen, Germany), a cobalt-chromium stent with semi-open cell design, has unique mechanical properties in this indication but is no longer available in France. To assess the efficiency of AndraStent XXL before PPVI. In this retrospective multicentre cohort study, 86 AndraStents XXL were implanted in 77 patients in 6 centres. PPVI was indicated mainly for pulmonary regurgitation (75.3%) in native or patched RVOT (88.3%). The stents were manually mounted on balloon catheters and delivered through sheaths using a conventional femoral approach. PPVI was performed successfully in 97.4% of patients after successful prestenting, generally during the same procedure (77.9%). There were no deaths associated with stent implantation, and four patients experienced five complications, mainly stent embolization, including one requiring surgery. Neither stent fracture nor dysfunction were observed in any patient during a mean follow-up of 19.2±8.7months. Stent analysis showed an excellent maximal stent expansion (97.1%) regardless of balloon size. A 22.3%±3.4 stent shortening with a 30mm balloon was observed. Implantation of large cobalt-chromium AndraStent XXL stents is efficient for prestenting before PPVI.
Sections du résumé
BACKGROUND
BACKGROUND
The indications for percutaneous pulmonary valve implantation (PPVI) have been extended to include large dysfunctional right ventricular outflow tracts (RVOTs). Prestenting of the RVOT is commonly performed before PPVI in order to ensure a stable landing zone. The AndraStent XXL (AndraMed GmbH, Reutlingen, Germany), a cobalt-chromium stent with semi-open cell design, has unique mechanical properties in this indication but is no longer available in France.
AIMS
OBJECTIVE
To assess the efficiency of AndraStent XXL before PPVI.
METHODS
METHODS
In this retrospective multicentre cohort study, 86 AndraStents XXL were implanted in 77 patients in 6 centres.
RESULTS
RESULTS
PPVI was indicated mainly for pulmonary regurgitation (75.3%) in native or patched RVOT (88.3%). The stents were manually mounted on balloon catheters and delivered through sheaths using a conventional femoral approach. PPVI was performed successfully in 97.4% of patients after successful prestenting, generally during the same procedure (77.9%). There were no deaths associated with stent implantation, and four patients experienced five complications, mainly stent embolization, including one requiring surgery. Neither stent fracture nor dysfunction were observed in any patient during a mean follow-up of 19.2±8.7months. Stent analysis showed an excellent maximal stent expansion (97.1%) regardless of balloon size. A 22.3%±3.4 stent shortening with a 30mm balloon was observed.
CONCLUSIONS
CONCLUSIONS
Implantation of large cobalt-chromium AndraStent XXL stents is efficient for prestenting before PPVI.
Identifiants
pubmed: 32081640
pii: S1875-2136(20)30020-6
doi: 10.1016/j.acvd.2019.12.004
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
113-120Informations de copyright
Copyright © 2020 Elsevier Masson SAS. All rights reserved.