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Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease

Abdelhak El Bouziani1, Lars S Witte1, Berto J Bouma1

  • 1Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

Journal of Clinical Medicine
|July 29, 2023
PubMed

Insights

Transcatheter atrioventricular valve repair is safe and feasible for adult congenital heart disease patients with severe regurgitation. These interventions improve heart function and symptoms, though long-term monitoring is crucial.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Congenital Heart Disease

Background:

  • Adult congenital heart disease (ACHD) patients face late complications like arrhythmias and heart failure.
  • Transcatheter valve interventions offer an alternative to surgery for acquired heart disease.
  • Limited data exists on percutaneous atrioventricular (AV) valve interventions in ACHD.

Purpose of the Study:

  • To evaluate the feasibility, safety, and outcomes of transcatheter AV valve interventions in ACHD patients.
  • To describe the technical aspects and hemodynamic effects of these procedures in a complex population.

Main Methods:

  • A descriptive cohort study of ACHD patients with severe AV valve regurgitation.
  • Included patients underwent transcatheter intervention between 2020-2022.
  • Data collected included demographics, clinical status, procedural details, and follow-up.

Main Results:

  • Five ACHD patients with severe/torrential AV regurgitation underwent various transcatheter repairs (TEER, valve-in-valve, Cardioband).
  • No periprocedural complications were observed.
  • All patients showed improvement in AV regurgitation and NYHA functional class, though one patient died from heart failure post-procedure.

Conclusions:

  • Transcatheter valve repair is feasible and safe in select complex ACHD patients.
  • A multidisciplinary heart team and advanced imaging are vital for individualized treatment strategies.
  • Long-term follow-up is necessary to assess the durability and clinical outcomes.
Abstract

Keywords:
Cardiobandadult congenital heart disease (ACHD)atrioventricular (AV) regurgitationhybridtranscatheter edge-to-edge repair (TEER)transcatheter valve repairvalve-in-valve (ViV)

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