Catheter-Based Techniques for Addressing Atrioventricular Valve Regurgitation in Adult Congenital Heart Disease Patients: A Descriptive Cohort

Journal of Clinical Medicine, vol. 12, pp. 4798

Abstract

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.

Authors 13

1. Abdelhak El Bouziani

   Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers

   Affiliation as printed

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

2. Lars S. Witte

   Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers

   Affiliation as printed

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

3. Berto Jorrit Bouma

   Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers

   Affiliation as printed

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

4. Monique R.M. Jongbloed Aachen Department of Anatomy and Embryology Department of Cardiology, CAHAL Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL)

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Anatomy and Embryology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands

   Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands

5. Daniëlle Robbers‐Visser

   Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers

   Affiliation as printed

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

6. Bart Straver

   Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers

   Affiliation as printed

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

7. Marcel A.M. Beijk

   Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers

   Affiliation as printed

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

8. Philippine Kiès Aachen Department of Cardiology, CAHAL Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL)

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands

9. David R. Koolbergen Aachen Department of Congenital Cardiothoracic Surgery Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL)

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Congenital Cardiothoracic Surgery, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands

10. Frank van der Kley Aachen Department of Cardiology, CAHAL Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL)

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands

11. Martin Jan Schalij Aachen Department of Cardiology, CAHAL Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL)

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands

12. Robbert J. de Winter

    Amsterdam UMC Location University of Amsterdam · Amsterdam University Medical Centers

    Affiliation as printed

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

13. Anastasia D. Egorova corresponding Aachen Department of Cardiology, CAHAL Center for Congenital Heart Disease Amsterdam-Leiden (CAHAL)

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands