Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort.
Abdelhak El Bouziani, Lars S Witte, Berto J Bouma, Monique R M Jongbloed, Dani��lle Robbers-Visser, Bart Straver, Marcel A M Beijk, Philippine Ki��s, David R Koolbergen, Frank van der Kley, Martin J Schalij, Robbert J de Winter, Anastasia D Egorova
Author Information
Abdelhak El Bouziani: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. ORCID
Lars S Witte: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. ORCID
Berto J Bouma: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Monique R M Jongbloed: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands. ORCID
Dani��lle Robbers-Visser: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Bart Straver: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Marcel A M Beijk: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. ORCID
Philippine Ki��s: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands.
David R Koolbergen: Department of Congenital Cardiothoracic Surgery, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands.
Frank van der Kley: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands.
Martin J Schalij: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands.
Robbert J de Winter: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Anastasia D Egorova: Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands. ORCID
INTRODUCTION: Increasing survival of adult congenital heart disease (ACHD) patients comes at the price of a range of late complications-arrhythmias, heart failure, and valvular dysfunction. Transcatheter valve interventions have become a legitimate alternative to conventional surgical treatment in selected acquired heart disease patients. However, literature on technical aspects, hemodynamic effects, and clinical outcomes of percutaneous atrioventricular (AV) valve interventions in ACHD patients is scarce. METHOD: This is a descriptive cohort from CAHAL (Center of Congenital heart disease Amsterdam-Leiden). ACHD patients with severe AV valve regurgitation who underwent a transcatheter intervention in the period 2020-2022 were included. Demographic, clinical, procedural, and follow-up data were collected from patient records. RESULTS: Five ACHD patients with severe or torrential AV valve regurgitation are described. Two patients underwent a transcatheter edge-to-edge repair (TEER), one patient underwent a valve-in-valve procedure, one patient received a Cardioband system, and one patient received both a Cardioband system and TEER. No periprocedural complications occurred. Post-procedural AV valve regurgitation as well as NYHA functional class improved in all patients. The median post-procedural NYHA functional class improved from 3.0 (IQR [2.5-4.0]) to 2.0 (IQR [1.5-2.5]). One patient died 9 months after the procedure due to advanced heart failure with multiorgan dysfunction. CONCLUSION: Transcatheter valve repair is feasible and safe in selected complex ACHD patients. A dedicated heart team is essential for determining an individualized treatment strategy as well as pre- and periprocedural imaging to address the underlying mechanism(s) of AV regurgitation and guide the transcatheter intervention. Long-term follow-up is essential to evaluate the clinical outcomes of transcatheter AV valve repair in ACHD patients.
