Cardiology 2013 (Full reference info)

Reference Type: Journal Article
Record Number: 843Author: Butera, G., Milanesi, O., Spadoni, I., Piazza, L., Donti, A., Ricci, C., Agnoletti, G., Pangrazi, A., Chessa, M. and Carminati, M.
Year: 2013
Title: Melody transcatheter pulmonary valve implantation. Results from the registry of the Italian Society of Pediatric Cardiology
Journal: Catheter Cardiovasc Interv
Volume: 81
Issue: 2
Pages: 310-6
Date: Feb
Short Title: Melody transcatheter pulmonary valve implantation. Results from the registry of the Italian Society of Pediatric Cardiology
Alternate Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X (Electronic)
1522-1946 (Linking)
DOI: 10.1002/ccd.24518
Accession Number: 22718682
Keywords: Adolescent
Adult
Aged
Cardiac Catheterization/adverse effects/*instrumentation/mortality
Chi-Square Distribution
Child
Device Removal
Echocardiography, Doppler, Color
Endocarditis, Bacterial/microbiology/surgery
Female
*Heart Valve Prosthesis/adverse effects
Heart Valve Prosthesis Implantation/adverse
effects/*instrumentation/methods/mortality
Humans
Italy
Kaplan-Meier Estimate
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Prospective Studies
Prosthesis Design
Prosthesis Failure
Prosthesis-Related Infections/microbiology/surgery
Pulmonary Valve Insufficiency/diagnosis/mortality/*therapy
Pulmonary Valve Stenosis/diagnosis/mortality/*therapy
Registries
Societies, Medical
Time Factors
Treatment Outcome
Young Adult
Abstract: BACKGROUND AND AIMS: Percutaneous implantation of pulmonary valve has been recently introduced in the clinical practice. Our aim was to analyze data of patients treated in Italy by using the Melody Medtronic valve. METHODS: Prospective, observational, multi-centric survey by means of a web-based database registry of the Italian Society of Pediatric Cardiology (SICP). RESULTS: Between October 2007 and October 2010, 63 patients were included in the registry (median age: 24 years; range 11-65 years). Forty subjects were in NYHA class I-II while 23 were in NYHA class III-IV. Patients included had a history of a median three previous surgeries (range 1-5) and a median of one previous cardiac catheterization (range 0-4). A cono-truncal disease was present in 39 patients, previous Ross operation in 9, and other diagnosis in 15. Indication to valve implantation was pure stenosis in 21 patients, pure regurgitation in 12, association of stenosis and regurgitation in 30. Implantation was performed in 61 subjects (97%). Pre-stenting was performed in 85% of cases. Median procedure time was 170 minutes (range 85-360). No significant regurgitation was recorded after procedure while the trans-pulmonary gradient reduced significantly. Early major complications occurred in seven subjects (11%). One death occurred in the early post-operative period in a severely ill subject. At a median follow-up of 30 months (range 12-48 months), three patients died due to underlying disease. Major complications occurred in six patients during follow-up (external electric cardioversion: one patient; herpes virus encephalitis: two patients; Melody valve endocarditis needing surgical explant: two patients; major fractures of the stent and need second Melody valve implantation: two patients). Freedom from valve failure at latest follow-up was 81.4% +/- 9%. CONCLUSION: Early results of the SICP registry on transcatheter Melody pulmonary valve implantation show that the procedure is safe and successful. Major concerns are related to the occurrence of stent fracture and bacterial endocarditis. Longer follow-up and larger series are needed.
Notes: Butera, Gianfranco
Milanesi, Ornella
Spadoni, Isabella
Piazza, Luciane
Donti, Andrea
Ricci, Christian
Agnoletti, Gabriella
Pangrazi, Alberta
Chessa, Massimo
Carminati, Mario
eng
Multicenter Study
2012/06/22 06:00
Catheter Cardiovasc Interv. 2013 Feb;81(2):310-6. doi: 10.1002/ccd.24518. Epub 2012 Nov 14.
URL: http://www.ncbi.nlm.nih.gov/pubmed/22718682
Author Address: Pediatric Cardiology, Policlinico San Donato IRCCS, San Donato Milanese, Italy. gianfra.but@lycos.com

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