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Interventions for Congenital Atrioventricular Valve Dysfunction: JACC Focus Seminar
Oliver M Barry1, Ismail Bouhout2, Susheel K Kodali3
1Division of Pediatric Cardiology, New York-Presbyterian-Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York, USA.
Insights
Transcatheter interventions are improving care for congenital heart disease (CHD) patients. New techniques for atrioventricular (AV) valve repair offer promising options for adults with CHD, expanding treatment possibilities.
Area of Science:
- Cardiology
- Interventional Cardiology
- Congenital Heart Disease Management
Background:
- Advances in congenital heart disease (CHD) care have significantly increased patient survival.
- Catheter-based interventions have been key to these improvements.
- However, interventions for congenital atrioventricular (AV) valve lesions remain challenging due to patient size and anatomy.
Purpose of the Study:
- To explore the evolving landscape of transcatheter interventions for atrioventricular (AV) valve disease in adult congenital heart disease (CHD) patients.
- To highlight the potential of new transcatheter techniques and technologies for managing congenital AV valve lesions.
- To discuss the translation of these advancements from adult non-CHD populations to adult CHD patients.
Main Methods:
- Review of current literature on transcatheter heart valve technologies.
- Analysis of the application of these technologies in adult patients without CHD.
- Assessment of the emerging translation of these practices to adult CHD populations.
Main Results:
- Transcatheter heart valve technologies are rapidly advancing.
- Many devices for AV valve repair and replacement are under investigation in non-CHD adults.
- Initial translation of select practices to adult CHD patients has commenced.
Conclusions:
- Transcatheter AV valve interventions present significant opportunities for the growing adult CHD population.
- These novel approaches may overcome limitations of traditional surgical methods for congenital AV valve lesions.
- The ongoing revolution in transcatheter therapies is poised to reshape the management of adult CHD.
Abstract:
Innovation and creativity have led to tremendous advancements in the care and management of patients with congenital heart disease (CHD) that have resulted in considerably increased survival. Catheter-based interventions have contributed significantly to these advancements. However, catheter-based interventions for congenital lesions of the atrioventricular (AV) valves have been limited in scope and effectiveness mainly because of patient size and anatomical challenges. Thus, surgical repair and replacement for congenital AV valve lesions have remained the preferred therapy. However, the ongoing transcatheter heart valve revolution has led to techniques and technologies that are changing the landscape, particularly for adult CHD patients. Many devices for AV valve repair and replacement are being studied in adult patients without CHD, and translation of select practices to CHD patients has begun, with many more to come. Transcatheter AV valve interventions represent exciting opportunities for the growing numbers of adult CHD patients.
