Abstract
Recent reports have suggested that the number of adults with congenital heart disease (CHD) has surpassed pediatric numbers and that approximately 1 in 150 adults has some form of CHD (Marelli et al., Circulation 115:163–172, 2007; Warnes et al., Circulation 118:2395–2451, 2008). Significant rates of intervention and re-intervention are required in this cohort of patients with one report demonstrating 20 % of young adults with CHD requiring cardiovascular surgery (Zomer et al., Circulation 124:2195–201, 2011). Increasingly, transcatheter alternatives to surgery exist in this population particularly in the field of transcatheter pulmonary valve replacement (tPVR), and recommendations for catheter intervention in adults with CHD have been published in the context of overall care of these patients (Warnes et al., Circulation 118:2395–2451, 2008). Case complexity will vary according to the underlying diagnosis ranging from more straightforward interventions such as atrial septal defect closure to complex stenting interventions for interatrial baffle leak in patients following atrial switch surgery for transposition of the great arteries. Many of the more complex patients may have had multiple previous interventions, and detailed review of previous data as well as sensible use of pre-procedural imaging techniques including cardiac CT and MRI is essential. This chapter will outline some of the procedural techniques and the diagnostic imaging tools used to optimize patient selection and procedural success. Outcome data where available will also be discussed in relation to the range of transcatheter interventions seen in this patient group.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Marelli AJ, Mackie AS, Ionescu-Ittu R, et al. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation. 2007;115:163–72.
Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2008;118:2395–451.
Zomer AC, Verheugt CL, Vaartjes I, et al. Surgery in adults with congenital heart disease. Circulation. 2011;124:2195–201.
Murphy JG, Gersh BJ, McGoon MD, et al. Long-term outcome after surgical repair of isolated atrial septal defect: follow-up at 27 to 32 years. N Engl J Med. 1990;323:1645–50.
Horvath KA, Burke RP, Collins Jr JJ, Cohn LH. Surgical treatment of adult atrial septal defect: early and long-term results. J Am Coll Cardiol. 1992;20:1156–9.
Attie F, Rosas M, Granados N, Zabal C, Buendia A, Calderon J. Surgical treatment for secundum atrial septal defect in patients >40 years old: a randomized clinical trial. J Am Coll Cardiol. 2001;38:2035–42.
Hanninen M, Kmet A, Taylor DA, Ross DB, Rebeyka I, Vonder Muhll IF. Atrial septal defect closure in the elderly is associated with excellent quality of life, functional improvement, and ventricular remodelling. Can J Cardiol. 2011;27:698–704.
Everett AD, Jennings J, Sibinga E, et al. Community use of the amplatzer atrial septal defect occluder: results of the multicenter MAGIC atrial septal defect study. Pediatr Cardiol. 2009;30:240–7.
Delaney JW, Li JS, Rhodes JF. Major complications associated with transcatheter atrial septal occluder implantation: a review of the medical literature and the manufacturer and user facility device experience (MAUDE) database. Congenit Heart Dis. 2007;2:256–64.
DiBardino DJ, McElhinney DB, Kaza AK, Mayer Jr JE. Analysis of the US Food and Drug Administration Manufacturer and User Facility Device Experience database for adverse events involving Amplatzer septal occluder devices and comparison with the Society of Thoracic Surgery congenital cardiac surgery database. J Thorac Cardiovasc Surg. 2009;137:1334–41.
Diab K, Kenny D, Hijazi ZM. Erosions, erosions, and erosions! Device closure of atrial septal defects: how safe is safe? Catheter Cardiovasc Interv. 2012;80:168–74.
Marini D, Ou P, Boudjemline Y, Kenny D, Bonnet D, Agnoletti G. Midterm results of percutaneous closure of very large atrial septal defects in children: role of multislice computed tomography. EuroIntervention. 2012;7:1317–25.
Mullen MJ, Hildick-Smith D, De Giovanni JV, et al. BioSTAR Evaluation STudy (BEST): a prospective, multicenter, phase I clinical trial to evaluate the feasibility, efficacy, and safety of the BioSTAR bioabsorbable septal repair implant for the closure of atrial-level shunts. Circulation. 2006;114:1962–7.
Chessa M, Butera G, Negura D, et al. Transcatheter closure of congenital ventricular septal defects in adult: mid-term results and complications. Int J Cardiol. 2009;133:70–3.
Al-Kashkari W, Balan P, Kavinsky CJ, et al. Percutaneous device closure of congenital & iatrogenic ventricular septal defects in adult patients. Catheter Cardiovasc Interv. 2011;77:260–7.
Carminati M, Butera G, Chessa M, Investigators of the European VSD Registry. Transcatheter closure of congenital ventricular septal defects: results of the European Registry. Eur Heart J. 2007;28:2361–8.
Fu YC, Bass J, Amin Z, et al. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase I trial. J Am Coll Cardiol. 2006;47:319–25.
Walsh MA, Bialkowski J, Szkutnik M, et al. Atrioventricular block after transcatheter closure of perimembranous ventricular septal defects. Heart. 2006;92:1295–7.
Ovaert C, Dragulescu A, Sluysmans T, et al. Early surgical removal of membranous ventricular septal occluder might allow recovery of atrio-ventricular block. Pediatr Cardiol. 2008;29:971–5.
Tucker EM, Pyles LA, Bass JL, Moller JH. Permanent pacemaker for atrioventricular conduction block after operative repair of perimembranous ventricular septal defect. J Am Coll Cardiol. 2007;50:1196–2000.
Yan C, Zhao S, Jiang S, et al. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults. Heart. 2007;93:514–8.
Lee CH, Leung YL, Kwong NP, et al. Transcatheter closure of patent ductus arteriosus in Chinese adults: immediate and long-term results. J Invasive Cardiol. 2003;15:26–30.
Valente AM, Lock JE, Gauvreau K, et al. Predictors of long-term adverse outcomes in patients with congenital coronary artery fistulae. Circ Cardiovasc Interv. 2010;3:134–9.
Fedson S, Jolly N, Lang RM, Hijazi ZM. Percutaneous closure of a ruptured sinus of Valsalva aneurysm using the Amplatzer Duct Occluder. Cathether Cardiovasc Interv. 2003;58:406–11.
Sivadasanpillai H, Valaparambil A, Sivasubramonian S. Percutaneous closure of ruptured sinus of Valsalva aneurysms: intermediate term follow-up results. EuroIntervention. 2010;6:214–9.
Bommart S, Bourdin A, Giroux MF, et al. Transarterial ethylene vinyl alcohol copolymer visualization and penetration after embolization of life threatening hemoptysis: technical and clinical outcomes. Cardiovasc Intervent Radiol. 2012;35:668–75.
Tabori NE, Love BA. Transcatheter occlusion of pulmonary arteriovenous malformations using the Amplatzer Vascular Plug II. Catheter Cardiovasc Interv. 2008;71:940–3.
Hijazi ZM, Fahey JT, Kleinman CS, Kopf GS, Hellenbrand WE. Hemodynamic evaluation before and after closure of fenestrated Fontan. An acute study of changes in oxygen delivery. Circulation. 1992;86:196–202.
Fawzy ME, Hassan W, Fadel BM, et al. Long-term results (up to 17 years) of pulmonary balloon valvuloplasty in adults and its effects on concomitant severe infundibular stenosis and tricuspid regurgitation. Am Heart J. 2007;153:433–8.
Kitchiner D, Jackson M, Walsh K, Peart I, Arnold R. The progression of mild congenital aortic valve stenosis from childhood into adult life. Int J Cardiol. 1993;42:217–23.
Cubeddu RJ, Jneid H, Don CW, et al. Retrograde versus antegrade aortic balloon valvuloplasty: immediate, short- and long-term outcomes at 2 years. Catheter Cardiovasc Interv. 2009;74:255–31.
McCrindle BW. Independent predictors of immediate results of percutaneous balloon aortic valvotomy in children. Valvuloplasty and Angioplasty of Congenital Anomalies (VACA) Registry Investigators. Am J Cardiol. 1996;77:286–93.
Balmer C, Beghetti M, Fasnacht M, Friedli B, Arbenz U. Balloon aortic valvoplasty in paediatric patients: progressive aortic regurgitation is common. Heart. 2004;90:77–81.
Brown DW, Dipilato AE, Chong EC, Lock JE, McElhinney DB. Aortic valve reinterventions after balloon aortic valvuloplasty for congenital aortic stenosis intermediate and late follow-up. J Am Coll Cardiol. 2010;56:1740–9.
de Lezo JS, Romero M, Segura J, et al. Long-term outcome of patients with isolated thin discrete subaortic stenosis treated by balloon dilation: a 25-year study. Circulation. 2011;124:1461–8.
McElhinney DB, Sherwood MC, Keane JF, del Nido PJ, Almond CS, Lock JE. Current management of severe congenital mitral stenosis: outcomes of transcatheter and surgical therapy in 108 infants and children. Circulation. 2005;112:707–14.
Cowley CG, Orsmond GS, Feola P, McQuillan L, Shaddy RE. Long-term, randomized comparison of balloon angioplasty and surgery for native coarctation of the aorta in childhood. Circulation. 2005;111:3453–6.
Forbes TJ, Kim DW, Du W, CCISC Investigators, et al. Comparison of surgical, stent, and balloon angioplasty treatment of native coarctation of the aorta an observational study by the CCISC (Congenital Cardiovascular Interventional Study Consortium). J Am Coll Cardiol. 2011;58:2664–74.
Forbes TJ, Garekar S, Amin Z, Congenital Cardiovascular Interventional Study Consortium (CCISC). Procedural results and acute complications in stenting native and recurrent coarctation of the aorta in patients over 4 years of age: a multi-institutional study. Catheter Cardiovasc Interv. 2007;70:276–85.
Kenny D, Cao QL, Kavinsky C, Hijazi ZM. Innovative resource utilization to fashion individualized covered stents in the setting of aortic coarctation. Catheter Cardiovasc Interv. 2011;78:413–8.
Chakrabarti S, Kenny D, Morgan G, et al. Balloon expandable stent implantation for native and recurrent coarctation of the aorta–prospective computed tomography assessment of stent integrity, aneurysm formation and stenosis relief. Heart. 2010;96:1212–6.
Kenny D, Amin Z, Slyder S, Hijazi ZM. Medium-term outcomes for peripheral pulmonary artery stenting in adults with congenital heart disease. J Interv Cardiol. 2011;24:373–7.
Helbing WA, Hansen B, Ottenkamp J, et al. Long-term results of atrial correction for transposition of the great arteries. Comparison of Mustard and Senning operations. J Thorac Cardiovasc Surg. 1994;108:363–72.
Bentham J, English K, Hares D, Gibbs J, Thomson J. Effect of transcatheter closure of baffle leaks following senning or mustard atrial redirection surgery on oxygen saturations and polycythaemia. Am J Cardiol. 2012;110:1046–50.
Porras D, McElhinney DB, Del Nido P, Lock JE, Meadows J, Marshall AC. Clinical and stent-related outcomes after transcatheter or operative placement of bare-metal stents in the ventricular septum or subvalvar systemic outflow tract. Circ Cardiovasc Interv. 2012;5:570–81.
Nordmeyer J, Lurz P, Khambadkone S, et al. Pre-stenting with a bare metal stent before percutaneous pulmonary valve implantation: acute and 1-year outcomes. Heart. 2011;97:118–23.
Eicken A, Ewert P, Hager A, et al. Percutaneous pulmonary valve implantation: two-c3ntre experience with more than 100 patients. Eur Heart J. 2011;32:1260–5.
McElhinney DB, Hellenbrand WE, Zahn EM, et al. Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation. 2010;122:507–16.
Kenny D, Hijazi ZM, Kar S, et al. Percutaneous implantation of the Edwards SAPIEN transcatheter heart valve for conduit failure in the pulmonary position: early phase 1 results from an international multicenter clinical trial. J Am Coll Cardiol. 2011;58:594–8.
Schievano S, Taylor AM, Capelli C, et al. First-in-man implantation of a novel percutaneous valve: a new approach to medical device development. EuroIntervention. 2010;5:745–50.
Roberts PA, Boudjemline Y, Cheatham JP, et al. Percutaneous tricuspid valve replacement in congenital and acquired heart disease. J Am Coll Cardiol. 2011;58:117–2.
Bentham JR, Qureshi S, Eicken A, Gibbs JL, Ballard G, Thomson JDR. Early percutaneous valve failure within bioprosthetic tricuspid tissue valve replacements. Catheter Cardiovasc Interv. 2013;82(3):428–35.
Ghawi H et al. Presented at PICS 2013, Miami, FL
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media New York
About this chapter
Cite this chapter
Kenny, D., Hibbeln, J., Hijazi, Z.M. (2014). Transcatheter Interventions in Adult Congenital Heart Disease. In: Saremi, F. (eds) Cardiac CT and MR for Adult Congenital Heart Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8875-0_22
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8875-0_22
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-8874-3
Online ISBN: 978-1-4614-8875-0
eBook Packages: MedicineMedicine (R0)