Transcatheter pulmonary valve replacement in congenital heart diseases

Chau, Anson C.M.

doi:10.1002/ped4.12359

Cited by 4 publications

(3 citation statements)

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“…237 Transcatheter pulmonary valve replacement has been developed in the last two decades and is a valuable nonsurgical alternative to restore the right ventricular outflow tract and right ventricular function and reduce patients' lifetime risks related to surgery. 238 Therefore, the risk of coronary artery obstruction should be assessed before stenting the conduit. Balloon dilation and pre-stenting can relieve conduit stenosis and provide a suitable landing zone for the valves.…”

Section: Tetralogy Of Fallot (Tof)mentioning

confidence: 99%

“…Surgery for TOF involves VSD closure and relief of the RVOTO to the greatest extent possible 237 . Transcatheter pulmonary valve replacement has been developed in the last two decades and is a valuable nonsurgical alternative to restore the right ventricular outflow tract and right ventricular function and reduce patients’ lifetime risks related to surgery 238 . Therefore, the risk of coronary artery obstruction should be assessed before stenting the conduit.…”

Section: Tetralogy Of Fallot (Tof)mentioning

confidence: 99%

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Congenital heart disease: types, pathophysiology, diagnosis, and treatment options

Meng,

Song,

Zhang

et al. 2024

MedComm

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Congenital heart disease (CHD) is a structural abnormality of the heart and/or great vessels and patients with CHD are at an increased risks of various morbidities throughout their lives and reduced long‐term survival. Eventually, CHD may result in various complications including heart failure, arrhythmias, stroke, pneumonia, and sudden death. Unfortunately, the exact etiology and pathophysiology of some CHD remain unclear. Although the quality of life and prognosis of patients with CHD have significantly improved following technological advancement, the influence of CHD is lifelong, especially in patients with complicated CHD. Thus, the management of CHD remains a challenge due to its high prevalence. Finally, there are some disagreements on CHD among international guidelines. In this review, we provide an update of the pathophysiology, diagnosis, and treatment in most common type of CHD, including patent foramen ovale, atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosus, coarctation of the aorta, transposition of the great arteries, congenitally corrected transposition of the great arteries, coronary anomalies, left and right ventricular outflow tract obstruction, tetralogy of Fallot and Ebstein anomaly. In particular, we focus on what is known and what is unknown in these areas, aiming to improve the current understanding of various types of CHD.

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Section: Tetralogy Of Fallot (Tof)mentioning

confidence: 99%

Section: Tetralogy Of Fallot (Tof)mentioning

confidence: 99%

Congenital heart disease: types, pathophysiology, diagnosis, and treatment options

Meng,

Song,

Zhang

et al. 2024

MedComm

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“…This condition is normally found in adult congenital heart disease (ACHD) which can manifest to transposition complexes and pressure overload. Consequently, it will lead into RV dysfunction [6][7][8][9] .…”

mentioning

confidence: 99%

A cost-utility analysis comparing transcatheter and surgical pulmonary valve replacement among Indonesia patients with a history of newborn right ventricular outflow tract correction

Annisa

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Transcatheter pulmonary valve replacement (TPVR) was launched since 2000. It indicated for cardiac patients who have the right ventricular outflow tract obstruction (RVOT) and a prior surgery history. TPVR have a shorter hospital stay, fewer complications, and a less-invasive method. However, TPVR is more expensive than surgical pulmonary valve replacement (SPVR). This raises access concerns for low income countries. There are no cost-effectiveness studies in Indonesia, and limited efficiency evidence due to rare disorder. It is a challenge in building the appropriate access strategies. Therefore, this study aims to investigate the cost-utility, resulted in total costs, quality-adjusted life-years (QALYs), life-years (LYs) and incremental cost-effectiveness ratio (ICER). The analysis included costs associated with hospitalization, inpatients and outpatients, and complication costs. A Markov simulation was modelled to estimate a hypothetical cohort of cardiac surgery experienced paediatric patients who require RVOT remodelling via either SPVR or TPVR during lifelong care. The methodology follows Indonesian health technology assessment guideline, and clinical inputs were derived from two meta-analyses and slightly modified by published articles. We include 3% discount rate of outcome and the consumer price index adjusted price in 2023. Sensitivity analyses were conducted both deterministically and probabilistically. Total costs between TPVR and SPVR were 71,033.15 USD and 23,946.02 USD, while QALYs gained accounted for 14.23 and 11.77 QALYs, respectively. Shown by ICER at 19,191.37 USD/QALY against one GDP of 3,900 USD, TPVR revealed that it was not cost-effective. For deterministic sensitivity analysis (DSA), utility index of initial TPVR has considerably impact while a price of TPVR is a fourth factor to ICER's. For probabilistic sensitivity analysis (PSA) confirm TPVR is more effective but more expensive. A 60-70% price reduction of TPVR will achieve the optimum price of TPVR provision.

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