Publications by authors named "D Balzer"
Background: A dilated native right ventricular outflow tract (RVOT) presents unique challenges for transcatheter management using balloon-expandable valves. The Alterra Adaptive Prestent was designed to expand transcatheter therapy to treat patients with dilated RVOTs.
Objectives: The aim of this study was to report 2-year outcomes of the main cohort of the ALTERRA (Multicenter Study of Congenital Pulmonic Valve Dysfunction Studying the SAPIEN 3 THV With the Alterra Adaptive Prestent) pivotal trial using the prestent with transcatheter pulmonary valve replacement.
Article Synopsis
- A patient with tetralogy of Fallot underwent implantation of a self-expanding transcatheter pulmonary valve.
- Unusually, this patient developed compression of the left coronary artery due to the implanted valve.
- Additionally, a fracture in the wire frame of the valve led to perforation of the aorta.
Newborns with ductal-dependent pulmonary blood flow require PGE1 infusion prior to ductal stenting to ensure patency of the PDA. There is no consensus, however, on management of PGE in the peri-procedural period in terms of timing of discontinuation of the drug. This review will focus on the rationale for continuing or discontinuing PGE, a brief review of some of the published recommendations, and will make some final recommendations regarding PGE management.
View Article and Find Full Text PDFTranscatheter pulmonary valve replacement after arterial switch operation.
Catheter Cardiovasc Interv
September 2024
Article Synopsis
- Patients with d-transposition of the great arteries (d-TGA) who have had an arterial switch operation (ASO) may experience right ventricular outflow tract (RVOT) issues, leading to the consideration of transcatheter pulmonary valve replacement (TPVR) as a treatment option.
- A study involving 33 patients showed a 66% success rate for TPVR, with most patients receiving either a Melody or SAPIEN valve, while some conditions like coronary compression prevented the procedure for a subset of patients.
- Post-TPVR, there was a significant reduction in RVOT gradient and a majority of patients reported minimal or no pulmonary regurgitation; however, a higher rate of reinterventions was noted in this
Background: The Alterra adaptive prestent is a novel self-expanding device designed to provide a landing zone for the 29 mm SAPIEN 3 valve to treat pulmonary regurgitation in patients with a right ventricular outflow tract that is too large for a balloon expandable valve alone. The mechanism of fixation for the Alterra prestent is radial force from the self-expanding stent frame, combined with a unique set of flared "tines" that protrude from both ends of the stent.
Aims, Methods, And Results: In this report, we describe 6 patients who underwent uncomplicated transcatheter pulmonary valve replacement with an Alterra adaptive prestent and SAPIEN 3 valve and had surveillance chest computed tomography (CT) scans performed 1 day to 21 months after implant.