Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T07:21:01.856Z Has data issue: false hasContentIssue false
  • English
  • Français

Is mesocardia with left-sided caval vein draining to coronary sinus a contraindication for a percutaneous pulmonary valve implantation? A case description

Published online by Cambridge University Press:  04 October 2017

Marinos Kantzis ,
Christoph M. Happel  and
Nikolaus A. Haas
Marinos Kantzis*
Affiliation:
Centre for Congenital Heart Disease, Heart and Diabetes Centre, Bad Oeynhausen, Ruhr University of Bochum, North Rhine Westphalia, Germany
Christoph M. Happel
Affiliation:
Centre for Congenital Heart Disease, Heart and Diabetes Centre, Bad Oeynhausen, Ruhr University of Bochum, North Rhine Westphalia, Germany Department of Pediatric Cardiology and Pediatric Intensive Care, Hannover Medical School, Hannover, Germany
Nikolaus A. Haas
Affiliation:
Centre for Congenital Heart Disease, Heart and Diabetes Centre, Bad Oeynhausen, Ruhr University of Bochum, North Rhine Westphalia, Germany Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig Maximillians University, Grossharden Clinic, Munich, Germany
*
Correspondence to: M. Kantzis, Department of Congenital Heart Defects, Heart and Diabetes Centre, Ruhr University Bochum, North Rhine Westphalia, Georgstrasse 11, D-32545 Bad Oeynhausen, Germany. Tel: +49 5731 973626; Fax: +49 5731 972300; E-mail: marinos.kantzis@gmail.com, mkantzis@hdz-nrw.de
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Although the right jugular vein approach for percutaneous pulmonary valve implantation is well described, there are no reports that describe a percutaneous pulmonary valve implantation through a left superior caval vein to coronary sinus pathway.

Case

A 14-year-old female with tetralogy of Fallot, mesocardia, left superior caval vein draining into the coronary sinus, and hemiazygos continuation of the inferior caval vein underwent ventricular septal defect closure, with homograft insertion from the right ventricle to the pulmonary artery, patch augmentation of the left pulmonary artery, and creation of an atrial communication. Thereafter followed numerous catheterisations and interventions with stent implantation for stenosis of the left pulmonary artery and the homograft, as did device closure of the atrial communication. When she was a 12-year-old, the indications for a percutaneous pulmonary valve implantation were fulfilled and she underwent implantation of a 22 mm Melody® valve through the left superior caval vein. The extra-stiff exchange wire was pre-formed into a “U-spiral”-type configuration, according to the underlying anatomy, in order to provide a smooth route for the delivery of stents, to create the landing zone, and for the implantation of the Melody “ensemble”. The procedure was performed under deep sedation according to our standard protocol. The duration of the procedure was 172 min and the radiation time was 24.9 min.

Conclusion

On the basis of this unique experience, percutaneous pulmonary valve implantation is safe and feasible even in patients with unusual anatomy. Crucial is the “U-spiral” shaped configuration of the guide wire.

Keywords

Percutaneous pulmonary valve implantationmesocardialeft superior vena cava to coronary sinusstents in right ventricle outflow tract
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 2 , February 2018 , pp. 229 - 233
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Lurz, P, Bonhoeffer, P, Taylor, AM. Percutaneous pulmonary valve implantation: an update. Expert Rev Cardiovasc Ther. 2009; 7: 823–832.CrossRefGoogle ScholarPubMed
2. Haas, NA, Moysich, A, Neudorf, U, et al. Percutaneous implantation of the Edwards SAPIEN(TM) pulmonic valve: initial results in the first 22 patients. Clin Res Cardiol 2013; 102: 119–128.CrossRefGoogle Scholar
3. Holzer, RJ, Hijazi, ZM. Transcatheter pulmonary valve replacement: state of the art- catheterization and cardiovascular interventions. Catheter Cardiovasc Intev 2016; 87: 117–128.CrossRefGoogle Scholar
4. Zampi, JD, Berman, DP, Bocks, ML, et al. Factors associated with the internal jugular venous approach for the malody transcatheter pulmonary valve implantation. Cardiol Young. 2015; 1–9.Google ScholarPubMed
5. Armstrong, AK, Balzer, DT, Cabalka, AK, et al. One-year follow-up of the Melody transcatheter pulmnary valve multicenter post-approval study. JACC Cardiovasc Interv 2014; 7: 1254–1262.CrossRefGoogle Scholar
6. Berman, DP, McElhinney, DB, Vincent, JA, Hellenbrand, WE, Zahn, EM. Feasibility and short-term outcomes of percutaneous transcatheter pulmonary valve replacement in small (<30 kg) children with dysfunctional right ventricular outflow tract conduits. Circ Cardiovasc Interv 2014; 7: 142–148.CrossRefGoogle ScholarPubMed
7. Hanslik, A, Moysich, A, Laser, KT, Mlczoch, E, Kececioglu, D, Haas, NA. Percutaneous closure of atrial septal defects in spontaneously breathing children under deep sedation: a feasible and safe concept. Pediatr Cardiol. 2014; 35: 215–222.CrossRefGoogle ScholarPubMed
8. Eicken, A, Ewert, P, Hager, A, et al. Percutaneous pulmonary valve implantation: two-centre experience with more than 100 patients. Eur Heart J. 2011; 32: 1260–1265.CrossRefGoogle ScholarPubMed