Management of a dissection of matrix P right ventricular-to-pulmonary artery conduit by implanting two pre-stents and a melody valve

Catheter Cardiovasc Interv. 2018 Jun;91(7):E64-E67. doi: 10.1002/ccd.26581. Epub 2016 Jun 1.

Abstract

Reconstructing the right ventricular outflow tract and pulmonary valve via a bovine-derived valve conduit such as Matrix-P-Xenograft is a common surgical repair technique for pulmonary atresia and ventricular septal defect. After conduit degeneration due to calcification or aneurysmal dilatation, percutaneous transvenous stenting of the right ventricular outflow tract followed by pulmonary valve implantation has become the standard interventional treatment. Applied to stenotic conduits, the method is considered safe and effective. An important but seldom-reported problem is graft failure related to the formation of a Matrix membrane due to inflammation and fibrosis inside the xenograft, which can cause serious problems when dissection and rupture occur during transcatheter intervention. The torn pseudomembrane may cause the complete obstruction of both pulmonary arteries, resulting in a life-threatening situation requiring rapid intervention, as in this case presentation. © 2016 Wiley Periodicals, Inc.

Keywords: congenital heart disease; matrix P plus conduit; minimally invasive revalvulation; percutaneous pulmonary valve implantation; pulmonary valve replacement; right ventricular outflow tract dysfunction.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Bioprosthesis*
  • Child
  • Echocardiography, Doppler, Color
  • Heart Septal Defects / physiopathology
  • Heart Septal Defects / surgery*
  • Heart Valve Prosthesis Implantation / adverse effects
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heterografts
  • Humans
  • Male
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / surgery*
  • Prosthesis Design
  • Prosthesis Failure*
  • Pulmonary Atresia / physiopathology
  • Pulmonary Atresia / surgery*
  • Pulmonary Valve / abnormalities
  • Pulmonary Valve / physiopathology
  • Pulmonary Valve / surgery*
  • Radiography, Interventional
  • Reoperation
  • Stents*
  • Treatment Outcome

Supplementary concepts

  • Pulmonary Atresia With Ventricular Septal Defect