Transcatheter Valve Replacement for Right-sided Valve Disease in Congenital Heart Patients.

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2018-09-17

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Abstract

Pulmonary and/or tricuspid valve dysfunction is common among individuals with congenital heart disease, and surgical intervention often carries prohibitive risks. Transcatheter valve replacement (TVR) of the right-sided cardiac valves has become a viable treatment option over the past two decades, while continued technological development aims to broaden its applicability to an even larger portion of those with repaired congenital heart disease. To date, two transcatheter valves have been approved for use in patients with dysfunctional right ventricular to pulmonary artery conduits as well as those with failing pulmonic bioprosthetic valves, and are also used off-label in the "native" RVOT and within surgically repaired/replaced but failing tricuspid valves. TVR has demonstrated comparable safety and short-term outcomes to that of surgical valve replacement. This article aims to review current available devices, focusing on their safety, efficacy and on and off label usage, while briefly describing some of the emerging devices and novel procedural techniques that will likely lead to significant expansion of transcatheter treatment of right sided valve disease in the future.

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10.1016/j.pcad.2018.09.003

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Gales, Jordan, Richard A Krasuski and Gregory A Fleming (2018). Transcatheter Valve Replacement for Right-sided Valve Disease in Congenital Heart Patients. Progress in cardiovascular diseases, 61(3-4). pp. 347–359. 10.1016/j.pcad.2018.09.003 Retrieved from https://hdl.handle.net/10161/17933.

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Scholars@Duke

Krasuski

Richard Andrew Krasuski

Professor of Medicine

Dr. Richard Krasuski is Director of the Adult Congenital Heart Center at Duke University Medical Center, the Director of Hemodynamic Research, and the Medical Director of the CTEPH Program. He is considered a thought leader in the fields of pulmonary hypertension and congenital heart disease. His research focus is in epidemiologic and clinical studies involving patients with pulmonary hypertension and patients with congenital heart disease. He is involved in multiple multicenter studies through the Alliance for Adult Research in Congenital Cardiology (AARCC). He has also helped to develop multiple research databases in these patient populations. He is Co-PI in the upcoming EPIPHANY Study examining the impact of medical and transcatheter interventions on RV-PA coupling in patients with chronic thromboembolic pulmonary hypertension. Over his career he has mentored over 80 students, residents and fellows and has published over 300 peer reviewed publications, book chapters and meeting abstracts. He is also the Chief Editor of Advances in Pulmonary Hypertension and on the editorial boards of several leading medical journals.

Fleming

Gregory Allan Fleming

Professor of Pediatrics

Clinical interests include pediatric and adult congenital interventional cardiac catheterization and treatment of infants and children with acquired and congenital heart disease and adults with congenital heart disease 

Research interests include assessment and development of interventional therapies for congenital heart disease, and perioperative management of infants and children with congenital heart disease requiring surgery.


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