The snared wire technique for Sapien valve implantation in the pulmonary position

Abstract

Objectives: Description of the snared wire technique (SWT) to facilitate the delivery of the Sapien valve in pulmonary position, and comparison with standard delivery technique. Background: Transcatheter pulmonary valve replacement (TPVR) with the Sapien delivery system has proven to be challenging. Therefore, alternative strategies for facilitating its delivery in this position are needed. Methods: Retrospective analysis of patients who underwent TPVR with or without the new SWT. The SWT was chosen as an elective strategy when the anatomy was judged to be challenging for TPVR (planned SWT) or as a rescue strategy when a standard delivery failed (rescue SWT).

The rescue snared wire technique for challenging transcatheter pulmonary valve implantation: a case series of two patients

“…While a conceptually similar snare technique has been previously described as a potential tip during troublesome crossing of surgical aortic valves with a THV, 4 Maschietto et al . 5 recently, and independently from our Institution, described the SWT by showing the results of 21 patients, who underwent a successful TPVI with this novel manoeuvre. The authors reported three cases of tricuspid valve injuries, all occurred in the rescue SWT group while none of the patients of the planned SWT group experienced any tricuspid valve injury, thus probably due to the extensive manipulation of the delivery system before adopting the SWT.…”