Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians
Aim: Transcatheter Pulmonary Valve Implantation (TPVI), when feasible, is the first-line approach to pulmonary valve replacement. Our aim was to obtain a picture of current TPVI practice in Italy. Methods: After conducting a literature review on TPVI, online surveys were devised by an Advisory Board...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
|
| Series: | International Journal of Cardiology Congenital Heart Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266666852300040X |
| _version_ | 1797401624132452352 |
|---|---|
| author | Biagio Castaldi Gianfranco Butera Massimo Chessa Lorenzo Galletti Alessandro Giamberti Luca Giugno Aurelio Secinaro Vladimiro Vida Giovanni Di Salvo Mario Carminati |
| author_facet | Biagio Castaldi Gianfranco Butera Massimo Chessa Lorenzo Galletti Alessandro Giamberti Luca Giugno Aurelio Secinaro Vladimiro Vida Giovanni Di Salvo Mario Carminati |
| author_sort | Biagio Castaldi |
| collection | DOAJ |
| description | Aim: Transcatheter Pulmonary Valve Implantation (TPVI), when feasible, is the first-line approach to pulmonary valve replacement. Our aim was to obtain a picture of current TPVI practice in Italy. Methods: After conducting a literature review on TPVI, online surveys were devised by an Advisory Board of 10 experts from the three Italian reference centers for congenital heart diseases and sent electronically to physicians working either in implanting center or in referral non-implanting cardiologic centers. Results: Approximately 450 physicians across Italy were invited to contribute. 82 (18%) physicians answered. EchoColorDoppler, electrocardiogram and cardiac magnetic resonance were considered the first line approach to monitor these patients, before and after TPVI.For non-implanting centers, reasons for non-referral of patients for PVR were: paucisymptomatic disease (67%) and patients’ poor adherence to disease management programs (41%), but also the lack of connections with specialized centers (33%). For implanters, the main reasons for refraining from TPVI were: high risk for coronary compression (67% first rank), the need for concomitant cardiac surgical procedures (39% first rank) and the unsuitable anatomy of the conduit (39% first rank). The availability of new larger valves of a self-expandable nature was indicated as a key technological development for expanding the cohort of patients currently eligible for TPVI. Conclusions: Despite a non-invasive imaging protocol for the follow up and selection of patients candidate to TPVI is well implemented in Italy, there is still a lack in connections between non-implanting and implanting centers. |
| first_indexed | 2024-03-09T02:12:40Z |
| format | Article |
| id | doaj.art-5f2984f542a846c4867ebe90b9591c99 |
| institution | Directory Open Access Journal |
| issn | 2666-6685 |
| language | English |
| last_indexed | 2024-03-09T02:12:40Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj.art-5f2984f542a846c4867ebe90b9591c992023-12-07T05:31:08ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852023-12-0114100478Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physiciansBiagio Castaldi0Gianfranco Butera1Massimo Chessa2Lorenzo Galletti3Alessandro Giamberti4Luca Giugno5Aurelio Secinaro6Vladimiro Vida7Giovanni Di Salvo8Mario Carminati9pediatric Cardiology Unit, Department of Women's and Children's Health, University of Padua, Italy; Corresponding author. Pediatric Cardiology Unit, Via Giustiniani 3, 35129 – Padua, Italy.Cardiology, Cardiac Surgery and Heart Lung Transplantation, ERN GUARD-Heart, Bambino Gesù Hospital and Research Institute, IRCCS, Rome, ItalyAdult Congenital Heart Disease Cardiology Unit - Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy; San Raffaele Vita e Salute University, Milan, ItalyCardiology, Cardiac Surgery and Heart Lung Transplantation, ERN GUARD-Heart, Bambino Gesù Hospital and Research Institute, IRCCS, Rome, ItalyCongenital Cardiac Surgery Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyDepartment of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyAdvanced Cardiothoracic Imaging Unit, Bambino Gesù Hospital and Research Institute, IRCCS, Rome, ItalyPediatric Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italypediatric Cardiology Unit, Department of Women's and Children's Health, University of Padua, ItalyDepartment of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, ItalyAim: Transcatheter Pulmonary Valve Implantation (TPVI), when feasible, is the first-line approach to pulmonary valve replacement. Our aim was to obtain a picture of current TPVI practice in Italy. Methods: After conducting a literature review on TPVI, online surveys were devised by an Advisory Board of 10 experts from the three Italian reference centers for congenital heart diseases and sent electronically to physicians working either in implanting center or in referral non-implanting cardiologic centers. Results: Approximately 450 physicians across Italy were invited to contribute. 82 (18%) physicians answered. EchoColorDoppler, electrocardiogram and cardiac magnetic resonance were considered the first line approach to monitor these patients, before and after TPVI.For non-implanting centers, reasons for non-referral of patients for PVR were: paucisymptomatic disease (67%) and patients’ poor adherence to disease management programs (41%), but also the lack of connections with specialized centers (33%). For implanters, the main reasons for refraining from TPVI were: high risk for coronary compression (67% first rank), the need for concomitant cardiac surgical procedures (39% first rank) and the unsuitable anatomy of the conduit (39% first rank). The availability of new larger valves of a self-expandable nature was indicated as a key technological development for expanding the cohort of patients currently eligible for TPVI. Conclusions: Despite a non-invasive imaging protocol for the follow up and selection of patients candidate to TPVI is well implemented in Italy, there is still a lack in connections between non-implanting and implanting centers.http://www.sciencedirect.com/science/article/pii/S266666852300040XTPVIPVRRVOT dysfunctionSurvey |
| spellingShingle | Biagio Castaldi Gianfranco Butera Massimo Chessa Lorenzo Galletti Alessandro Giamberti Luca Giugno Aurelio Secinaro Vladimiro Vida Giovanni Di Salvo Mario Carminati Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians International Journal of Cardiology Congenital Heart Disease TPVI PVR RVOT dysfunction Survey |
| title | Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians |
| title_full | Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians |
| title_fullStr | Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians |
| title_full_unstemmed | Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians |
| title_short | Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians |
| title_sort | transcatheter pulmonary valve implantation in clinical practice a nationwide survey of cardiological implanting and non implanting physicians |
| topic | TPVI PVR RVOT dysfunction Survey |
| url | http://www.sciencedirect.com/science/article/pii/S266666852300040X |
| work_keys_str_mv | AT biagiocastaldi transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT gianfrancobutera transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT massimochessa transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT lorenzogalletti transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT alessandrogiamberti transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT lucagiugno transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT aureliosecinaro transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT vladimirovida transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT giovannidisalvo transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians AT mariocarminati transcatheterpulmonaryvalveimplantationinclinicalpracticeanationwidesurveyofcardiologicalimplantingandnonimplantingphysicians |