Right ventricular outflow tract obstruction in right ventricular-pulmonary artery conduits or bioprosthetic valve
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Right ventricular outflow tract obstruction Microchapters |
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Classification |
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Differentiating Right ventricular outflow tract obstruction from other Diseases |
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Right ventricular outflow tract obstruction in right ventricular-pulmonary artery conduits or bioprosthetic valve On the Web |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Evaluation and Follow-Up After Right Ventricular-Pulmonary Artery Conduit or Prosthetic valve (DO NOT EDIT)[1]
| Class I |
| "1. After surgical relief of RVOT obstruction with a conduit or prosthetic valve, patients should be followed up on a 1- to 2-year basis with echocardiography Doppler assessment of RV systolic pressure and function, as well as a measurement of the gradient across the RVOT. (Level of Evidence: C) " |
Reintervention in Patients With Right Ventricular–Pulmonary Artery Conduit or Bioprosthetic Pulmonary Valve Stenosis (DO NOT EDIT)[1]
| Class I |
| "1. Surgeons with training and expertise in CHD should perform operations for patients with severe pulmonary prosthetic valve stenosis (peak gradient greater than 50 mm Hg) or conduit regurgitation and any of the following:" |
| "a. Decreased exercise capacity.(Level of Evidence: C)" |
| "b. Depressed RV function. (Level of Evidence: C)" |
| "c. At least moderately enlarged RV end-diastolic size.(Level of Evidence: C)" |
| "d. At least moderate TR. (Level of Evidence: C)" |
| Class IIa |
| "1. Either surgical or percutaneous therapy can be useful in symptomatic patients with discrete RV pulmonary artery conduit obstructive lesions with greater than 50% diameter narrowing or when a bioprosthetic pulmonary valve has a peak gradient by Doppler greater than 50 mm Hg or a mean gradient greater than 30 mm Hg. (Level of Evidence: C)" |
| "2. Either surgical or percutaneous therapy can be useful in asymptomatic patients when a pulmonary bioprosthetic valve has a peak Doppler gradient greater than 50 mm Hg. (Level of Evidence: C)" |
| Class IIb |
| "1. Surgical intervention may be considered preferable to percutaneous catheter intervention when an associated Maze procedure is being considered for the treatment of atrial arrhythmias.(Level of Evidence: C)" |
References
- ↑ 1.0 1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.