Article

PDF
Access to the PDF text
Advertising



Archives of cardiovascular diseases
Volume 105, n° 8-9
pages 404-413 (août 2012)
Doi : 10.1016/j.acvd.2012.05.002
Received : 14 February 2012 ;  accepted : 3 May 2012
Outcomes and safety of transcatheter pulmonary valve replacement in patients with large patched right ventricular outflow tracts
Résultats de l’implantation percutanée de valves pulmonaires chez les patients ayant des voies d’éjection droite patchées
 

Figure 1




Figure 1 : 

Angiograms showing calibration of right ventricular outflow tract (RVOT) and pulmonary artery (PA) for selection of patients. (A and B) Angiograms in four-chamber (A) and lateral (B) views without balloon with a marked catheter. (C) Angiogram showing inflation of a balloon catheter in the RVOT and simultaneous injection in the Mullins sheath. (D) Angiogram showing inflation of a balloon catheter in the left PA and simultaneous injection in the Mullins sheath. Measurements are made according to the diameter of the balloon at the level of the expected landing zone.


Figure 2




Figure 2 : 

Angiograms from a patient with significant right ventricle to pulmonary artery gradient. (A) Four-chamber view. (B) Lateral view showing a restriction at the annulus level. (C) Angiogram obtained during implantation of the bare-metal stent showing a notch on the stent. (D) Angiogram following Melody valve placement showing complete opening of the stents and excellent valve function.


Figure 3




Figure 3 : 

Angiograms demonstrating the jailing technique in a patient with a large right ventricular outflow tract (RVOT). (A and B) Angiograms in lateral (A) and four-chamber (B) views showing the anatomy of the RVOT and pulmonary artery (PA) tree. (C) Left PA angiogram prior to bare-metal stent insertion showing adequate diameter of the left PA. (D) Final angiogram showing the preparation for Melody valve implantation and normal flow through the jailed right PA.


Figure 4




Figure 4 : 

Angiograms demonstrating the jailing technique in a patient with a large right ventricular outflow tract (RVOT) and stenosis of the left pulmonary artery (LPA). (A) Angiogram in four-chamber view showing the anatomy of the RVOT and LPA stenosis prior to stent implant. (B) Final angiogram showing excellent function of the Melody valve.


Figure 5




Figure 5 : 

Angiograms demonstrating the Russian dolls technique in a patient with single right pulmonary artery (PA). (A and B) Angiogram in oblique view during diastole (A) and systole (B) showing the change of diameter during the cardiac cycle. (C) Bare-metal stent insertion to reduce the diameter of the PA. (D) Final result showing excellent function of the Melody valve.


Figure 6




Figure 6 : 

Schematic representation of the management of primarily unfavourable right ventricular outflow tract (RVOT) prior to Melody valve implantation; PA: pulmonary artery.

EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline