Publications by authors named "Cabalka A"
Background: Tricuspid valve-in-valve (TVIV) implantation has traditionally included post-procedure overnight in-hospital observation with next-day discharge. Recently, our practice has shifted toward same-day discharge for most patients after vascular access site hemostasis and adequate recovery from anesthesia. However, data on the safety of this approach remains scarce.
View Article and Find Full Text PDFRadiation Exposure and Protection for (Assumed) Pregnant Interventional Cardiologists and Electrophysiologists.
J Soc Cardiovasc Angiogr Interv
September 2024
Background: Concern about fetus radiation dose and assumed health effects remains a barrier for women considering a career in invasive cardiology. However, there is a lack of real-world fetus exposure data that can be used to support career decisions. The purpose of this work was to measure radiation exposure to invasive cardiologists which would contribute to dose to the fetus during pregnancy.
View Article and Find Full Text PDFHarmony Transcatheter Pulmonary Valve Successfully Implanted via Transjugular Approach.
J Soc Cardiovasc Angiogr Interv
February 2024
Feasibility of intentional bioprosthetic valve fracture in the tricuspid position.
Catheter Cardiovasc Interv
September 2024
Article Synopsis
- * An international registry collected data from ten patients across six centers, revealing a significant increase in the inner diameter of the tricuspid valve after the procedure without any major complications noted.
- * Results indicated that the method led to a notable decrease in heart pressure gradients, suggesting improved blood flow and potentially reducing the risk of prosthesis mismatch.
Article Synopsis
- Fontan pathway obstruction refers to a narrowing in the cavo-pulmonary pathways, which can lead to serious complications.
- This report describes the first documented case using a new Fontan conduit rehabilitation procedure that includes intravascular lithotripsy.
- The procedure successfully enlarged the pathway significantly, demonstrating a promising advancement in treatment.
Background: Anatomic selection for Harmony valve implant is determined with the aid of a screening report and perimeter plot (PP) that depicts the perimeter-derived radius along the right ventricular outflow tract (RVOT) and projects device oversizing. The PP provides an estimation of suitability for implant, but its sensitivity as a screening method is unknown. This study was performed to describe anatomic features and outcomes in patients who underwent Harmony TPV25 implant despite a PP that predicted inadequate oversizing.
View Article and Find Full Text PDFArticle Synopsis
- Transcatheter pulmonary valve replacement (TPVR) using the Harmony valve is a new treatment for patients with pulmonary regurgitation, showing promising short-term safety and efficacy since FDA approval in 2021.
- In a study involving 243 patients, the majority of whom had tetralogy of Fallot, acute technical success was achieved in nearly all cases, with a low rate of serious complications.
- At a median follow-up of 13 months, 98% of patients maintained good hemodynamic function, indicating excellent short-term outcomes, while ongoing monitoring is needed for long-term results.
We present a 19-year-old female with history of d-transposition of the great arteries status post-arterial switch operation.
View Article and Find Full Text PDFBackground: There are limited data about changes in cardiac function (cardiac reverse remodeling) and heart failure indices after transcatheter tricuspid valve-in-valve replacement (TT-VIVR). The purpose of this study was to evaluate cardiac reverse remodeling and temporal changes in heart failure indices after TT-VIVR in adults with congenital heart disease.
Methods: Retrospective cohort study of adults with congenital heart disease that underwent TT-VIVR and had >6 months of follow-up (January 1, 2011, to April 30, 2023).
Background: The Harmony TPV25 transcatheter pulmonary valve (Medtronic Inc.) is constructed with a self-expanding stent frame comprising six zigged nitinol wires sewn together and covered with knitted polyester fabric, with flared inflow and outflow ends and a porcine pericardial valve sutured to the central portion of the device. It was approved for treatment of pulmonary regurgitation after prior right ventricular outflow tract repair in 2021.
View Article and Find Full Text PDFArticle Synopsis
- The Harmony transcatheter pulmonary valve (TPV) is the first FDA-approved treatment for severe pulmonary regurgitation in patients with either native or surgically repaired right ventricular outflow tracts.
- A study assessed the one-year safety and effectiveness of the Harmony TPV in a large patient group, revealing that most patients experienced significant improvements without deaths reported.
- Results indicated high success rates, with 98% of TPV22 and 91% of TPV25 patients free from major complications at one year, highlighting the valve's favorable clinical outcomes and the need for continued long-term evaluations.
Background: Fontan pathway stenosis is a well-known complication after palliation. Percutaneous stenting is effective for angiographic/hemodynamic relief of Fontan obstruction, but its clinical impact in adults remains unknown.
Methods: This was a retrospective cohort of 26 adults undergoing percutaneous stenting for Fontan obstruction from 2014 to 2022.
Transcatheter Pulmonary Valve Implantation: Valve-in-Frame Procedure.
JACC Cardiovasc Interv
September 2022
Transcatheter pulmonary valve replacement (TPVR) is a minimally invasive procedure for treatment of right ventricular outflow tract (RVOT) dysfunction in surgically repaired congenital heart diseases. TPVR is performed in these patients to avoid the high risk and complexity of repeat surgeries. Several TPVR devices are now available to be placed in the right ventricle (RV) to pulmonary artery (PA) conduit, native RVOT, or surgical bioprosthetic valves.
View Article and Find Full Text PDFBackground: Transcatheter pulmonary valve (TPV) replacement (TPVR) has become the standard therapy for postoperative pulmonary outflow tract dysfunction in patients with a prosthetic conduit/valve, but there is limited information about risk factors for death or reintervention after this procedure.
Objectives: This study sought to evaluate mid- and long-term outcomes after TPVR in a large multicenter cohort.
Methods: International registry focused on time-related outcomes after TPVR.
Background: Endocarditis has emerged as one of the most impactful adverse events after transcatheter pulmonary valve replacement (TPVR), but there is limited information about risk factors for and outcomes of this complication.
Objectives: The purpose of this study was to evaluate risk factors for and outcomes of endocarditis in a large multicenter cohort.
Methods: The authors established an international registry focused on characterizing endocarditis after TPVR, including the incidence, risk factors, characteristics, and outcomes.
Coronary artery fistulas (CAFs) are rare coronary anomalies that are usually diagnosed incidentally with cardiac imaging. Small CAFs are generally asymptomatic and can close over time, while some untreated medium or large CAFs can enlarge, leading to clinical sequelae such as cardiac chamber enlargement or myocardial ischemia. With the advancement of transcatheter equipment and techniques, CAFs have been increasingly closed using a percutaneous approach.
View Article and Find Full Text PDFObjective: We compared 5-year outcomes of transcatheter pulmonary valve (TPV) replacement with the Melody TPV in the post-approval study (PAS) and the investigational device exemption (IDE) trial.
Background: As a condition of approval of the Melody TPV after the IDE trial, the Food and Drug Administration required that a PAS be conducted to evaluate outcomes of TPV replacement in a "real-world" environment. The 5-year outcomes of the PAS have not been published, and the IDE and PAS trials have not been compared.