Prosthetic Pulmonary Valve Stenosis: A Different Way to Solve the Problem Thomas Schroeter, MD, Philipp Lurz, MD, PhD, Philipp Kiefer, MD, Mahmoud Wehbe,

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Presentation transcript:

Prosthetic Pulmonary Valve Stenosis: A Different Way to Solve the Problem Thomas Schroeter, MD, Philipp Lurz, MD, PhD, Philipp Kiefer, MD, Mahmoud Wehbe, MD, Ingo Dähnert, MD, PhD The Annals of Thoracic Surgery Volume 100, Issue 3, Pages 1103-1105 (September 2015) DOI: 10.1016/j.athoracsur.2014.11.065 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Angiography revealing the malrotation of the 2011 implanted biological pulmonary prosthesis (Medtronic Mosaic, 27 mm) with functional stenosis. For better illustration, the prosthesis framework is traced. 1 = pulmonary valve prosthesis, 2 = pulmonary artery, 3 = aortic valve prosthesis. The Annals of Thoracic Surgery 2015 100, 1103-1105DOI: (10.1016/j.athoracsur.2014.11.065) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Result after implantation of the first stent (AndraStent XXL), which rotates the prosthesis toward the pulmonary artery. 1 = right ventricular outflow tract; 2 = sheet; 3 = aortic valve prosthesis. The Annals of Thoracic Surgery 2015 100, 1103-1105DOI: (10.1016/j.athoracsur.2014.11.065) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Situs after implantation of three stents in prosthesis and pulmonary artery. The old prosthesis was effectively rotated and the malposition was corrected. The Melody valve is in position, but not yet opened. 1 = right ventricular outflow tract; 2 = Melody valve delivery system; 3 = aortic valve prosthesis. The Annals of Thoracic Surgery 2015 100, 1103-1105DOI: (10.1016/j.athoracsur.2014.11.065) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Completion angiography. It revealed good prosthetic function with out paravalvular leak. No relevant gradient across the valve could be measured. 1 = right ventricular outflow tract; 2 = pigtail catheter; 3 = aortic valve prosthesis. The Annals of Thoracic Surgery 2015 100, 1103-1105DOI: (10.1016/j.athoracsur.2014.11.065) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions