Page 122 - Journal of Structural Heart Disease Volume 5, Issue 4

Meeting Abstracts
184
159. Table 1. Basal clinical characteristics. Tricuspid
require valve replacement and future reinterventions with high morbidity and mortality.Our aim: present an alter- native on off-label TTVR and TPVR using a bioprosthesis developed and manufactured in Brazil and demonstrate our initial experience in the these positions, since this pros- thesis was initially designed for use in aortic position.
Methods:
Case report. The procedures were performed in a hybrid suit. The bioprosthesis used Braile Inovare (Braile Biomedical, Brazil). The valve is a balloon-expandable prosthesis with a lozenge cobalt-chromium frame, 20mm height and a single sheet of bovine pericardium com- posing the leaflets with diameters: 20 to 28 mm. Vascular access: right jugular vein by dissection and femoral vein; one case required mini-thoracotomy. Pre-dilatation and balloon measurement were performed before implan- tation of the bioprosthesis. The procedures were guided using 3D transesophageal echocardiography (TEE) and fluoroscopy.
Results
Were performed 10 cases using the Braile Inovare valve: 8 in tricuspid and 2 in pulmonary position. Inclusion criteria:
Variables
N=10
Male
Age (years)
Weight (kg)
NYHA III-IV class, n (%)
Previous interventions ≥ 3 times, n (%)
Pulmonary Male
Age (years)
Weight (kg)
NYHA III-IV class, n (%)
Previous interventions ≥ 3 times, n (%)
8
62.5% (5)
30, 49 (11, 9-46, 8) 63 (26-96)
4 (50%)
6 (75%)
2
100% (2)
19, 7 (16, 8-22, 6) 65, 7 (58, 5-73) 0
2 (100%)
Introduction: Transcatheter tricuspid and pulmonary valve-in-valve replacement (TTVR and TPVR) has emerged as an alternative to high-risk open-heart surgery for patients with degenerated bioprostheses, who usually
159. Table 2. Clinical and procedural characteristics.
Individual characteristics
Procedure
Clinical outcomes
Age
Gender
Weight (kg)
Initial Diagn.
Approach
Valve x Balloon size (mm)
Echo pre
Echo post
Discharge (days)
FC pre
FC post
Followup (days)
Tricuspid valve in valve
1 32 M 60
2 21 M 70
3 42 F 70
4 16 M 50
5 34 F 59
6 46 F 96
7 37 M 73
8 11 M 26
Pulmonary valve in valve
1 22 M 58
2 16 M 73
Ebstein Anomaly RJV
Infective RJV endocarditis (IE)
Ebstein Anomaly atrial
T4F + tricuspid IE RJV VSD + tricusp. Regurgitation RJV Ebstein Anomaly RVJ Reumatic fever RVJ Tricuspid dysplasia RFV
T4F RFV/LFV Pulmonar atresia RFV
26 / 28 26 / 28
28 / 30 28 / 30 30 / 30 30 / 30 30 / 30 30 / 30
20 / 22 20 / 22
6 3 18 12 5 11
9 3 7
9 5 18 11 6 10 13 5 8
8 4 18 13 9 16
96 38 20
48 80 36* II II 24
IE: Infective endocarditis; T4F: Fallot Tetralogy; *death of sepsis
I I 1162 II II 1138
III I 724 III I 270 II III 741 II II 417 III II 574 III II 705
I--
Journal of Structural Heart Disease, August 2019
Volume 5, Issue 4:75-205