Journal «Angiology and Vascular Surgery» • 

2021 • VOLUME 27 • №2

First serial transcatheter implantation of pulmonary valve using MedLab-KT prosthesis

Bazylev V.V., Shmatkov M.G., Voevodin A.B., Chernogrivov I.E.

Federal Centre of Cardiovascular Surgery of the RF Ministry of Public Health, Penza, Russia

Background. Surgical treatment of "blue" congenital heart defects frequently implies various interventions on the outlet portion of the right ventricle or pulmonary artery trunk. Most often used are various conduits, reconstructing the outlet portion of the right ventricle and pulmonary artery. Most patients having previously endured the mentioned interventions, would in the remote terms require repeat operative procedures for stenosis or insufficiency on the pulmonary valve or the implanted conduit. Taking into account complexity and the risk of open interventions, the current trends are towards more frequent use of transcatheter implantation of the pulmonary valve.

Objective. The purpose of this work is to present the first serial experience with hybrid transventricular implantation of an original Russian-made valve into the position of the pulmonary artery.

Patients and methods. We retrospectively studied a series of 5 clinical cases who from July 2019 to May 2020 at the Federal Centre of Cardiovascular Surgery (Penza) had underwent hybrid transventricular implantation of the first Russian-made valve-containing stent (MedLab-KT) into the position of the pulmonary valve, with the stent’s closing component consisting of leaflets made of polytetrafluoroethylene.

Results. 3 patients underwent implantation of valve №25 and 2 subjects received valve №23, with all cases yielding good immediate results. The haemodynamic parameters of the implanted prosthesis were optimal. In all cases, the significant gradient was absent and regurgitation did not exceed grade I. There was no in-hospital mortality.

The method of hybrid prosthetic repair of the pulmonary valve via the transapical right-ventricular access from the left lateral mini-thoracotomy was aimed at reducing potential risks of artificial circulation, also contributing to a significant decrease in the traumatic nature of surgical treatment of patients requiring a repeat intervention for pulmonary valve pathology.

KEY WORDS: congenital heart defect, conduit, pulmonary artery stenosis, transcatheter implantation, mini-thoracotomy.

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