Multicenter Experience Evaluating Transcatheter Pulmonary Valve Replacement in Bovine Jugular Vein (Contegra) Right Ventricle to Pulmonary Artery Conduits

Brian H. Morray, Doff B. McElhinney, Younes Boudjemline, Marc Gewillig, Dennis W. Kim, Elena K. Grant, Martin L. Bocks, Mary H. Martin, Aimee K. Armstrong, Darren Berman, Saar Danon, Mark Hoyer, Jeffrey W. Delaney, Henri Justino, Athar M. Qureshi, Jeffery J. Meadows, Thomas K. Jones

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background - Follow-up of transcatheter pulmonary valve replacement (TPVR) with the Melody valve has demonstrated good short-term and long-term outcomes, but there are no published studies focused on valve performance in the Contegra bovine jugular vein conduit. Methods and Results - This is a retrospective, multicenter study of the short- and intermediate-term outcomes of Melody TPVR within the Contegra conduit in the right ventricle to pulmonary artery position. Data from 13 centers were included in the analysis. During the study period, 136 patients underwent 139 catheterizations for attempted Melody TPVR with a median follow-up of 3 years (1 day to 9.1 years). Of the 136 patients, 117 underwent successful Melody TPVR. Two patients underwent a second Melody TPVR. The majority of patients underwent placement of ≥1 stents before transcatheter pulmonary valve implantation. There was a significant reduction in peak conduit pressure gradient acutely after transcatheter pulmonary valve implantation (39 versus 10 mm Hg; P<0.001). At most recent follow-up, the maximum pulmonary valve gradient by echocardiogram remained significantly reduced relative to prevalve implant measurements (65.9 versus 27.3 mm Hg; P<0.001). The incidence of Melody transcatheter pulmonary valve stent fracture (3.4%) and infectious endocarditis (4.3%) were both low. Serious adverse events occurred in 3 patients. Conclusions - Melody TPVR in Contegra conduits is safe and effective and can be performed in a wide range of conduit sizes with preserved valve function and low incidence of stent fracture and endocarditis.

Original languageEnglish (US)
Article numbere004914
JournalCirculation: Cardiovascular Interventions
Volume10
Issue number6
DOIs
StatePublished - Jun 1 2017
Externally publishedYes

Fingerprint

Pulmonary Valve
Jugular Veins
Pulmonary Artery
Heart Ventricles
Stents
Endocarditis
Incidence
Catheterization
Multicenter Studies
Retrospective Studies
Pressure

Keywords

  • adult
  • aneurysm
  • angioplasty
  • endocarditis
  • hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Multicenter Experience Evaluating Transcatheter Pulmonary Valve Replacement in Bovine Jugular Vein (Contegra) Right Ventricle to Pulmonary Artery Conduits. / Morray, Brian H.; McElhinney, Doff B.; Boudjemline, Younes; Gewillig, Marc; Kim, Dennis W.; Grant, Elena K.; Bocks, Martin L.; Martin, Mary H.; Armstrong, Aimee K.; Berman, Darren; Danon, Saar; Hoyer, Mark; Delaney, Jeffrey W.; Justino, Henri; Qureshi, Athar M.; Meadows, Jeffery J.; Jones, Thomas K.

In: Circulation: Cardiovascular Interventions, Vol. 10, No. 6, e004914, 01.06.2017.

Research output: Contribution to journalArticle

Morray, BH, McElhinney, DB, Boudjemline, Y, Gewillig, M, Kim, DW, Grant, EK, Bocks, ML, Martin, MH, Armstrong, AK, Berman, D, Danon, S, Hoyer, M, Delaney, JW, Justino, H, Qureshi, AM, Meadows, JJ & Jones, TK 2017, 'Multicenter Experience Evaluating Transcatheter Pulmonary Valve Replacement in Bovine Jugular Vein (Contegra) Right Ventricle to Pulmonary Artery Conduits', Circulation: Cardiovascular Interventions, vol. 10, no. 6, e004914. https://doi.org/10.1161/CIRCINTERVENTIONS.116.004914
Morray, Brian H. ; McElhinney, Doff B. ; Boudjemline, Younes ; Gewillig, Marc ; Kim, Dennis W. ; Grant, Elena K. ; Bocks, Martin L. ; Martin, Mary H. ; Armstrong, Aimee K. ; Berman, Darren ; Danon, Saar ; Hoyer, Mark ; Delaney, Jeffrey W. ; Justino, Henri ; Qureshi, Athar M. ; Meadows, Jeffery J. ; Jones, Thomas K. / Multicenter Experience Evaluating Transcatheter Pulmonary Valve Replacement in Bovine Jugular Vein (Contegra) Right Ventricle to Pulmonary Artery Conduits. In: Circulation: Cardiovascular Interventions. 2017 ; Vol. 10, No. 6.
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abstract = "Background - Follow-up of transcatheter pulmonary valve replacement (TPVR) with the Melody valve has demonstrated good short-term and long-term outcomes, but there are no published studies focused on valve performance in the Contegra bovine jugular vein conduit. Methods and Results - This is a retrospective, multicenter study of the short- and intermediate-term outcomes of Melody TPVR within the Contegra conduit in the right ventricle to pulmonary artery position. Data from 13 centers were included in the analysis. During the study period, 136 patients underwent 139 catheterizations for attempted Melody TPVR with a median follow-up of 3 years (1 day to 9.1 years). Of the 136 patients, 117 underwent successful Melody TPVR. Two patients underwent a second Melody TPVR. The majority of patients underwent placement of ≥1 stents before transcatheter pulmonary valve implantation. There was a significant reduction in peak conduit pressure gradient acutely after transcatheter pulmonary valve implantation (39 versus 10 mm Hg; P<0.001). At most recent follow-up, the maximum pulmonary valve gradient by echocardiogram remained significantly reduced relative to prevalve implant measurements (65.9 versus 27.3 mm Hg; P<0.001). The incidence of Melody transcatheter pulmonary valve stent fracture (3.4{\%}) and infectious endocarditis (4.3{\%}) were both low. Serious adverse events occurred in 3 patients. Conclusions - Melody TPVR in Contegra conduits is safe and effective and can be performed in a wide range of conduit sizes with preserved valve function and low incidence of stent fracture and endocarditis.",
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AU - Morray, Brian H.

AU - McElhinney, Doff B.

AU - Boudjemline, Younes

AU - Gewillig, Marc

AU - Kim, Dennis W.

AU - Grant, Elena K.

AU - Bocks, Martin L.

AU - Martin, Mary H.

AU - Armstrong, Aimee K.

AU - Berman, Darren

AU - Danon, Saar

AU - Hoyer, Mark

AU - Delaney, Jeffrey W.

AU - Justino, Henri

AU - Qureshi, Athar M.

AU - Meadows, Jeffery J.

AU - Jones, Thomas K.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background - Follow-up of transcatheter pulmonary valve replacement (TPVR) with the Melody valve has demonstrated good short-term and long-term outcomes, but there are no published studies focused on valve performance in the Contegra bovine jugular vein conduit. Methods and Results - This is a retrospective, multicenter study of the short- and intermediate-term outcomes of Melody TPVR within the Contegra conduit in the right ventricle to pulmonary artery position. Data from 13 centers were included in the analysis. During the study period, 136 patients underwent 139 catheterizations for attempted Melody TPVR with a median follow-up of 3 years (1 day to 9.1 years). Of the 136 patients, 117 underwent successful Melody TPVR. Two patients underwent a second Melody TPVR. The majority of patients underwent placement of ≥1 stents before transcatheter pulmonary valve implantation. There was a significant reduction in peak conduit pressure gradient acutely after transcatheter pulmonary valve implantation (39 versus 10 mm Hg; P<0.001). At most recent follow-up, the maximum pulmonary valve gradient by echocardiogram remained significantly reduced relative to prevalve implant measurements (65.9 versus 27.3 mm Hg; P<0.001). The incidence of Melody transcatheter pulmonary valve stent fracture (3.4%) and infectious endocarditis (4.3%) were both low. Serious adverse events occurred in 3 patients. Conclusions - Melody TPVR in Contegra conduits is safe and effective and can be performed in a wide range of conduit sizes with preserved valve function and low incidence of stent fracture and endocarditis.

AB - Background - Follow-up of transcatheter pulmonary valve replacement (TPVR) with the Melody valve has demonstrated good short-term and long-term outcomes, but there are no published studies focused on valve performance in the Contegra bovine jugular vein conduit. Methods and Results - This is a retrospective, multicenter study of the short- and intermediate-term outcomes of Melody TPVR within the Contegra conduit in the right ventricle to pulmonary artery position. Data from 13 centers were included in the analysis. During the study period, 136 patients underwent 139 catheterizations for attempted Melody TPVR with a median follow-up of 3 years (1 day to 9.1 years). Of the 136 patients, 117 underwent successful Melody TPVR. Two patients underwent a second Melody TPVR. The majority of patients underwent placement of ≥1 stents before transcatheter pulmonary valve implantation. There was a significant reduction in peak conduit pressure gradient acutely after transcatheter pulmonary valve implantation (39 versus 10 mm Hg; P<0.001). At most recent follow-up, the maximum pulmonary valve gradient by echocardiogram remained significantly reduced relative to prevalve implant measurements (65.9 versus 27.3 mm Hg; P<0.001). The incidence of Melody transcatheter pulmonary valve stent fracture (3.4%) and infectious endocarditis (4.3%) were both low. Serious adverse events occurred in 3 patients. Conclusions - Melody TPVR in Contegra conduits is safe and effective and can be performed in a wide range of conduit sizes with preserved valve function and low incidence of stent fracture and endocarditis.

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KW - angioplasty

KW - endocarditis

KW - hemodynamics

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