A novel method to prevent recurrent balloon rupture during dilation of heavily calcified conduits in preparation for transcatheter pulmonary valve placement

Hazeem, Anas Abu; Aldoss, Osamah; Fagan, Thomas E.

doi:10.1002/ccd.26054

Cited by 4 publications

(4 citation statements)

References 7 publications

(13 reference statements)

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“…Another advantage of the 65‐cm DrySeal sheath is illustrated in cases of ruptured or deformed balloons. Rupture of the Edwards delivery balloon could occur during valve deployment especially in patients with calcified bioprostheses or homografts 16,17 . Our group experienced two cases with difficult retrieval of a ruptured delivery balloon with the e‐sheath, resulting in a embolization the tip of the e‐sheath in one case and tricuspid valve injury in the other case.…”

Section: Discussionmentioning

confidence: 92%

“…Rupture of the Edwards delivery balloon could occur during valve deployment especially in patients with calcified bioprostheses or homografts. 16,17 Our group experienced two cases with difficult retrieval of a ruptured delivery balloon with the e-sheath, resulting in a embolization the tip of the esheath in one case and tricuspid valve injury in the other case. It is suspected that manipulation of the system during retrieval directly caused the tricuspid valve injury in the latter case.…”

Section: Discussionmentioning

confidence: 99%

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Utility of the long DrySeal sheath in facilitating transcatheter pulmonary valve implantation with the Edwards Sapien 3 valve

Fukuda¹,

Tan²,

Sadeghi³

et al. 2020

Cathet Cardio Intervent

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Objective: To assess the utility of the 65-cm-long Gore DrySeal sheath when compared to the standard 36-cm-long Edwards expandable sheath (e-sheath) for transcatheter pulmonary valve implantation (TPVI) with the Edwards Sapien 3 valve. Methods: All patients who underwent TPVI with the Sapien 3 valve, excluding those performed via hybrid approach, at our center between September 2015 and November 2019 were retrospectively reviewed and compared between two groups. Results: A total of 94 patients were enrolled; 29 patients underwent TPVI with the Sapien valve using the DrySeal sheath and 65 underwent TPVI using the e-sheath. The height and body weight of patients implanted using the DrySeal sheath ranged from 137 to 193 cm and from 33 to 129 kg, respectively. Valve delivery time was significantly shorter in the DrySeal group (median time 4 min 33 s vs. 9 min 6 s, p = .002). There were no complications in the DrySeal group (0/27). Nine procedural complications occurred in the e-sheath group (9/65), five of which were potentially directly related to sheath choice, including tricuspid valve injury in four and embolization of the tip of the e-sheath during retrieval of a ruptured balloon in one patient. Conclusions: TPVI with the Sapien 3 valve using the 65-cm-long DrySeal sheath facilitates faster and safer valve implantation when compared to the e-sheath.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Utility of the long DrySeal sheath in facilitating transcatheter pulmonary valve implantation with the Edwards Sapien 3 valve

Fukuda¹,

Tan²,

Sadeghi³

et al. 2020

Cathet Cardio Intervent

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show abstract

“…This method has been previously anecdotally described to prevent recurrent balloon rupture during dilation of heavily calcified conduits before percutaneous pulmonary valve implantation, without implanting a stent. 7 This case illustrates a useful approach in the case of incomplete stent expansion in the right ventricle outflow tract owing to balloon rupture. It has allowed both to fully expand the stent and to safely withdraw the ruptured balloon.…”

Section: Discussionmentioning

confidence: 95%

“…To our knowledge, this is the first case reported in the literature illustrating the double-balloon technique to complete stent expansion after rupture of the balloon on which the stent was mounted. This method has been previously anecdotally described to prevent recurrent balloon rupture during dilation of heavily calcified conduits before percutaneous pulmonary valve implantation, without implanting a stent 7 …”

Section: Discussionmentioning

confidence: 99%

Management of balloon rupture during a percutaneous pulmonary valve implantation procedure

2018

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Percutaneous pulmonary valve implantation is increasingly adopted as an alternative procedure to surgery in dysfunctional homograft, and in patients with "native" or wide right ventricle outflow tract dysfunction. Pre-stenting is mandatory in this category of patients for many reasons, one of which is to create an adequate landing zone for the bioprosthesis. Here we report on a tricky situation that occurred during pre-stenting, and we describe how we successfully overcame it.

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Balloon Angioplasty

Nguyen¹,

Truong²,

Bui³

et al. 2020

Practical Handbook of Advanced Interventional Cardiology

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A novel method to prevent recurrent balloon rupture during dilation of heavily calcified conduits in preparation for transcatheter pulmonary valve placement

Abstract: This case illustrates a novel method of using the body of a ruptured balloon to protect subsequent balloons from rupture due to heavy conduit calcification. This method requires the presence of two venous access lines but might save time, effort, and cost from repeated balloon ruptures.

Cited by 4 publications

References 7 publications

Utility of the long DrySeal sheath in facilitating transcatheter pulmonary valve implantation with the Edwards Sapien 3 valve

Utility of the long DrySeal sheath in facilitating transcatheter pulmonary valve implantation with the Edwards Sapien 3 valve

Management of balloon rupture during a percutaneous pulmonary valve implantation procedure

Balloon Angioplasty

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