학술논문
Introduction of transcatheter edge-to-edge repair in patients with congenital heart disease at a children's hospital.
Document Type
Academic Journal
Author
Jolley MA; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Sulentic A; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Amin S; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Gupta M; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Ching S; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Cianciulli A; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Wang Y; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Sabin P; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Zelonis C; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Daemer M; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Silvestro E; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Coleman K; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Ford LK; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Edelson JB; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Ruckdeschel ES; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Cohen MS; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Nicolson SC; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.; Gillespie MJ; Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Source
Publisher: Wiley-Liss Country of Publication: United States NLM ID: 100884139 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-726X (Electronic) Linking ISSN: 15221946 NLM ISO Abbreviation: Catheter Cardiovasc Interv Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Atrioventricular valve regurgitation (AVVR) is a devastating complication in children and young adults with congenital heart disease (CHD), particularly in patients with single ventricle physiology. Transcatheter edge-to-edge repair (TEER) is a rapidly expanding, minimally invasive option for the treatment of AVVR in adults that avoids the morbidity and mortality associated with open heart surgery. However, application of TEER in in CHD and in children is quite novel. We describe the development of a peri-procedural protocol including image-derived pre-intervention simulation, with successful application to four patients.
Aims: To describe the initial experience using the MitraClip system for TEER of dysfunctional systemic atrioventricular valves in patients with congential heart disease within a pediatric hospital.
Methods: A standardized screening and planning process was developed using cardiac magnetic resonance imaging, three dimensional echocardiography and both virtual and physical simulation. Procedures were performed using the MitraClip G4 system and patients were clinically followed post-intervention.
Results: A series of four CHD patients with at least severe AVVR were screened for suitability for TEER with the MitraClip system: three patients had single ventricle physiology and Fontan palliation, and one had repair of a common atrioventricular canal defect. Each patient had at least severe systemic AVVR and was considered at prohibitively high risk for surgical repair. Each patient underwent a standardized preprocedural screening protocol and image-derived modeling followed by the TEER procedure with successful clip placement at the intended location in all cases.
Conclusions: The early results of our protocolized efforts to introduce TEER repair of severe AV valve regurgitation with MitraClip into the CHD population within our institution are encouraging. Further investigations of the use of TEER in this challenging population are warranted.
(© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
Aims: To describe the initial experience using the MitraClip system for TEER of dysfunctional systemic atrioventricular valves in patients with congential heart disease within a pediatric hospital.
Methods: A standardized screening and planning process was developed using cardiac magnetic resonance imaging, three dimensional echocardiography and both virtual and physical simulation. Procedures were performed using the MitraClip G4 system and patients were clinically followed post-intervention.
Results: A series of four CHD patients with at least severe AVVR were screened for suitability for TEER with the MitraClip system: three patients had single ventricle physiology and Fontan palliation, and one had repair of a common atrioventricular canal defect. Each patient had at least severe systemic AVVR and was considered at prohibitively high risk for surgical repair. Each patient underwent a standardized preprocedural screening protocol and image-derived modeling followed by the TEER procedure with successful clip placement at the intended location in all cases.
Conclusions: The early results of our protocolized efforts to introduce TEER repair of severe AV valve regurgitation with MitraClip into the CHD population within our institution are encouraging. Further investigations of the use of TEER in this challenging population are warranted.
(© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)