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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3677_Библиотеки_им_академика_М_И_Перельмана
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12 Valvular Abnormalities
a
bc
de f
Fig. 12.4 Same patient Fig 12.3 who underwent the TPVI procedure. (a) Photograph depicts the
implantation of a self-expandable transcatheter pulmonary valve (30 × 38mm Pulsta valve) using
a knitted nitinol wire backbone and a trileaet a-Gal-free porcine pericardial valve. (b) 2D TEE in
the UE PA SAX view shows the delivery catheter (indicated by yellow arrows) passing the pulmonary annulus. In (c), the deployment of the transcatheter Pulsta valve (TPV) at the pulmonary
artery (PA) can be seen. The release of the transcatheter Pulsta valve is depicted in (d). The color
Doppler TEE image in (e) shows a mosaic turbulent ow at the TPV. (f) A post-procedural PA
angiograph displays the transcatheter Pulsta valve (indicated by yellow arrows) positioned in the
PA below the PA bifurcation
12.2 Transcatheter Pulmonary Valve Implantation (TPVI) inPatients…
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a
bc
245
Fig. 12.5 Three-dimensional TEE was performed for transcatheter pulmonary valve implantation
with Pulsta bioprosthetic valve in the same patient. (a) 3D TEE and MPR were conducted on the
pulmonary valve after successful implantation of the Pulsta bioprosthetic valve. The plane in green
bounding box provides an en prole view of the transcatheter Pulsta valve (TPV), and the plane in
blue bounding box displays an enface view. The 3D planimetry of the TPV in mid-systole is
depicted in the plane in yellow bounding box. (b) In the 3D TEE mode, the LAX view showcases
the perspective of the pulmonary artery (PA) and right ventricular outow tract (RVOT). The
Pulsta bioprosthetic valve was implanted at the pulmonary trunk between the RVOT and the bifurcation of the PA. (R PA right pulmonary artery, L PA left pulmonary artery, DAo descending aorta).
(c) 3D TEE mode shows an enface view from the perspective of the pulmonary valve. The number
of leaets and coaptation can be observed
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12 Valvular Abnormalities
a b
Fig. 12.6 A three-dimensional transesophageal echocardiography (3D TEE) image with color
Doppler of the same patient who underwent a transcatheter pulmonary valve implantation (TPVI)
procedure. (a) En face horizontal view of the transcatheter Pulsta valve (TPV) in a 3D TEE color
Doppler image displays mild valvular regurgitation (indicated by an arrow (Video 12.1). (b) 3D
TEE en prole longitudinal pulmonary artery (PA) view shows that one leaet of the TPV is not
fully expanding, causing mild regurgitation (indicated by an arrow), which suggests that the TPV
is oversized (Video 12.2)
References
1. Bonhoeffer P, Boudjemline Y, Saliba Z, etal. Percutaneous replacement of pul-
monary valve in a right‐ventricle to pulmonary‐artery prosthetic conduit with
valve dysfunction. Lancet. 2000;356:1403–5.
2. Lurz P, Coats L, Khambadkone S, etal. Percutaneous pulmonary valve implan-
tation: impact of evolving technology and learning curve on clinical outcome.
Circulation. 2008;117:1964–72.
3. Chatterjee A, Bajaj NS, McMahon WS, et al. Transcatheter pulmonary valve
implantation: a comprehensive systematic review and meta‐analyses of observational studies. J Am Heart Assoc 2017;6:e006432.
4. Muller J, Engelhardt A, Fratz S, etal. Improved exercise performance and qual-
ity of life after percutaneous pulmonary valve implantation. Int J Cardiol.
2014;173:388–92.
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