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Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation.
Arch Cardiovasc Dis. 2020 Feb; 113(2):113-120.AC

Abstract

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

To assess the efficiency of AndraStent XXL before PPVI.

METHODS

In this retrospective multicentre cohort study, 86 AndraStents XXL were implanted in 77 patients in 6 centres.

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

Implantation of large cobalt-chromium AndraStent XXL stents is efficient for prestenting before PPVI.

Authors+Show Affiliations

CHU Toulouse, Pediatric and Congenital Cardiology, Children's Hospital, Université de Toulouse, 31300 Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, INSERM U1048, I2MC, 1, Avenue Jean-Poulhès, BP 84225, Toulouse, France. Electronic address: clement.karsenty@hotmail.fr.Centre de Référence Malformations Cardiaques Congénitales, Complexes-M3C, Necker Hospital for Sick Children, George-Pompidou European Hospital, Assistance Publique des Hopitaux de Paris (AP-HP), 75015 Paris, France.Paediatric Cardiology and Cardiac Surgery Services, Royal Brompton and Harefield NHS Foundation Trust, London, UK.Fetal and Pediatric Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.Centre de Référence Malformations Cardiaques Congénitales, Complexes-M3C, Necker Hospital for Sick Children, George-Pompidou European Hospital, Assistance Publique des Hopitaux de Paris (AP-HP), 75015 Paris, France.Pediatric and Congenital Cardiology, M3C Regional Reference CHD Centre, University Hospital, Marseille, France.Pediatric and Congenital Cardiology, M3C Regional Reference CHD Centre, University Hospital, Marseille, France.Department of Cardiology, M3C Regional Reference CHD Centre, CHU Grenoble, France.Adult Congenital Heart Centre, Royal Brompton Hospital, London, UK.Pôle des cardiopathies congénitales de l'enfant et de l'adulte, centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France.Pôle des cardiopathies congénitales de l'enfant et de l'adulte, centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France.Pôle des cardiopathies congénitales de l'enfant et de l'adulte, centre de référence malformations cardiaques congénitales complexes (M3C), hôpital Marie-Lannelongue, université Paris-Sud, université Paris-Saclay, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

32081640

Citation

Karsenty, Clement, et al. "Right Ventricular Outflow Tract Prestenting With AndraStent XXL Before Percutaneous Pulmonary Valve Implantation." Archives of Cardiovascular Diseases, vol. 113, no. 2, 2020, pp. 113-120.
Karsenty C, Malekzadeh-Milani S, Fraisse A, et al. Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation. Arch Cardiovasc Dis. 2020;113(2):113-120.
Karsenty, C., Malekzadeh-Milani, S., Fraisse, A., Gewillig, M., Bonnet, D., Aldebert, P., Ovaert, C., Bouvaist, H., Kempny, A., Houeijeh, A., Petit, J., & Hascoet, S. (2020). Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation. Archives of Cardiovascular Diseases, 113(2), 113-120. https://doi.org/10.1016/j.acvd.2019.12.004
Karsenty C, et al. Right Ventricular Outflow Tract Prestenting With AndraStent XXL Before Percutaneous Pulmonary Valve Implantation. Arch Cardiovasc Dis. 2020;113(2):113-120. PubMed PMID: 32081640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation. AU - Karsenty,Clement, AU - Malekzadeh-Milani,Sophie, AU - Fraisse,Alain, AU - Gewillig,Marc, AU - Bonnet,Damien, AU - Aldebert,Philippe, AU - Ovaert,Caroline, AU - Bouvaist,Helene, AU - Kempny,Aleksander, AU - Houeijeh,Ali, AU - Petit,Jerome, AU - Hascoet,Sebastien, Y1 - 2020/02/18/ PY - 2019/06/30/received PY - 2019/12/03/revised PY - 2019/12/12/accepted PY - 2020/2/23/pubmed PY - 2020/6/23/medline PY - 2020/2/22/entrez KW - Endoprothèse KW - Implantation percutanée de valve pulmonaire KW - Percutaneous pulmonary valve implantation KW - Right ventricular outflow tract KW - Stent KW - Voie de sortie ventriculaire droite SP - 113 EP - 120 JF - Archives of cardiovascular diseases JO - Arch Cardiovasc Dis VL - 113 IS - 2 N2 - 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: To assess the efficiency of AndraStent XXL before PPVI. METHODS: In this retrospective multicentre cohort study, 86 AndraStents XXL were implanted in 77 patients in 6 centres. 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: Implantation of large cobalt-chromium AndraStent XXL stents is efficient for prestenting before PPVI. SN - 1875-2128 UR - https://www.unboundmedicine.com/medline/citation/32081640/Right_ventricular_outflow_tract_prestenting_with_AndraStent_XXL_before_percutaneous_pulmonary_valve_implantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1875-2136(20)30020-6 DB - PRIME DP - Unbound Medicine ER -