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2 results on '"Zahn, Evan M."'

1. Endocarditis After Transcatheter Pulmonary Valve Replacement

Author

McElhinney, Doff B, Søndergaard, Lars, Armstrong, Aimee K, Bergersen, Lisa, Padera, Robert F, Balzer, David T, Lung, Te-Hsin, Berger, Felix, Zahn, Evan M, Gray, Robert G, Hellenbrand, William E, Kreutzer, Jacqueline, Eicken, Andreas, Jones, Thomas K, Ewert, Peter, McElhinney, Doff B, Søndergaard, Lars, Armstrong, Aimee K, Bergersen, Lisa, Padera, Robert F, Balzer, David T, Lung, Te-Hsin, Berger, Felix, Zahn, Evan M, Gray, Robert G, Hellenbrand, William E, Kreutzer, Jacqueline, Eicken, Andreas, Jones, Thomas K, and Ewert, Peter

Abstract

BACKGROUND: Endocarditis has emerged as one of the most concerning adverse outcomes in patients with congenital anomalies involving the right ventricular outflow tract (RVOT) and prosthetic valves.OBJECTIVES: The aim of this study was to evaluate rates and potential risk factors for endocarditis after transcatheter pulmonary valve replacement in the prospective Melody valve trials.METHODS: All patients in whom a transcatheter pulmonary valve (TPV) was implanted in the RVOT as part of 3 prospective multicenter studies comprised the analytic cohort. The diagnosis of endocarditis and involvement of the TPV were determined by the implanting investigator.RESULTS: A total of 309 patients underwent transcatheter pulmonary valve replacement (TPVR) and were discharged with a valve in place. The median follow-up duration was 5.1 years, and total observation until study exit was 1,660.3 patient-years. Endocarditis was diagnosed in 46 patients (median 3.1 years after TPVR), and a total of 35 patients were reported to have TPV-related endocarditis (34 at the initial diagnosis, 1 with a second episode). The annualized incidence rate of endocarditis was 3.1% per patient-year and of TPV-related endocarditis was 2.4% per patient-year. At 5 years post-TPVR, freedom from a diagnosis of endocarditis was 89% and freedom from TPV-related endocarditis was 92%. By multivariable analysis, age ≤12 years at implant (hazard ratio: 2.3; 95% confidence interval: 1.2 to 4.4; p = 0.011) and immediate post-implant peak gradient ≥15 mm Hg (2.7; 95% confidence interval: 1.4 to 4.9; p = 0.002) were associated with development of endocarditis and with development of TPV-related endocarditis (age ≤12 years: 2.8; 95% confidence interval: 1.3 to 5.7; p = 0.006; gradient ≥15 mm Hg: 2.6; 95% confidence interval: 1.3 to 5.2; p = 0.008).CONCLUSIONS: Endocarditis is an important adverse outcome following TVPR in children and adults with post-operative congenital heart disease inv

Published
2018

2. Intermediate follow-up following intravascular stenting for treatment of coarctation of the aorta

Author

Children's Hospital of Michigan, Wayne State University, Detroit, Michigan ; Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, University of California at San Francisco, Division of Cardiology, San Francisco, California, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP, Brazil, The Congenital Heart Institute at Miami, Children's Hospital and Arnold Palmer Women and Children's Hospital, Orlando, Florida, Children's Hospital of Omaha, University of Nebraska Creighton University, Omaha, Nebraska, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, Guy's Hospital, London, England, Columbus Children's Hospital, Ohio State University, Columbus, Ohio, Children's Hospital of Mississippi, University of Mississippi/Jackson, Mississipi, University of Chicago, Division of Cardiology, Chicago, Illinois, Mayo Clinic, Rochester, Minnesota, Cardiovascular Center Bethanien, Frankfurt, Germany, Children's Hospital of Iowa, University of Iowa, Iowa City, Iowa, Medical University of South Carolina, Division of Cardiology, Charleston, South Carolina, Children's Memorial Hospital, Northwestern University, Lincoln Park, Illinois, Duke Children's Heart Program, Duke University, Durham, North Carolina, Seattle Children's Hospital, University of Washington, Seattle, Washington, Babies and Children's Hospital of New York, Columbia Presbyterian, New York, New York, Forbes, Thomas J., Moore, Phillip, Pedra, Carlos A. C., Zahn, Evan M., Nykanen, David, Amin, Zahid, Garekar, Swati, Teitel, David, Qureshi, Shakeel A., Cheatham, John P., Ebeid, Makram R., Hijazi, Ziyad M., Sandhu, Satinder, Hagler, Donald J., Sievert, Horst, Fagan, Thomas E., Ringwald, Jeremy, Du, Wei, Tang, Liwen, Wax, David F., Rhodes, John, Johnston, Troy A., Jones, Thomas K., Turner, Daniel R., Pass, Robert, Torres, Alejandro, Hellenbrand, William E., Children's Hospital of Michigan, Wayne State University, Detroit, Michigan ; Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201, University of California at San Francisco, Division of Cardiology, San Francisco, California, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, SP, Brazil, The Congenital Heart Institute at Miami, Children's Hospital and Arnold Palmer Women and Children's Hospital, Orlando, Florida, Children's Hospital of Omaha, University of Nebraska Creighton University, Omaha, Nebraska, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, Guy's Hospital, London, England, Columbus Children's Hospital, Ohio State University, Columbus, Ohio, Children's Hospital of Mississippi, University of Mississippi/Jackson, Mississipi, University of Chicago, Division of Cardiology, Chicago, Illinois, Mayo Clinic, Rochester, Minnesota, Cardiovascular Center Bethanien, Frankfurt, Germany, Children's Hospital of Iowa, University of Iowa, Iowa City, Iowa, Medical University of South Carolina, Division of Cardiology, Charleston, South Carolina, Children's Memorial Hospital, Northwestern University, Lincoln Park, Illinois, Duke Children's Heart Program, Duke University, Durham, North Carolina, Seattle Children's Hospital, University of Washington, Seattle, Washington, Babies and Children's Hospital of New York, Columbia Presbyterian, New York, New York, Forbes, Thomas J., Moore, Phillip, Pedra, Carlos A. C., Zahn, Evan M., Nykanen, David, Amin, Zahid, Garekar, Swati, Teitel, David, Qureshi, Shakeel A., Cheatham, John P., Ebeid, Makram R., Hijazi, Ziyad M., Sandhu, Satinder, Hagler, Donald J., Sievert, Horst, Fagan, Thomas E., Ringwald, Jeremy, Du, Wei, Tang, Liwen, Wax, David F., Rhodes, John, Johnston, Troy A., Jones, Thomas K., Turner, Daniel R., Pass, Robert, Torres, Alejandro, and Hellenbrand, William E.

Abstract

Background : We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques. Methods and Results : Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005. About 27% (160/588) procedures were followed up by further IAI of their aorta (MRI/CT/repeat cardiac catheterization) after initial stent procedures. Abnormal imaging studies included: the presence of dissection or aneurysm formation, stent fracture, or the presence of reobstruction within the stent (instent restenosis or significant intimal build-up within the stent). Forty-one abnormal imaging studies were reported in the intermediate follow-up at median 12 months (0.5–92 months). Smaller postintervention of the aorta (CoA) diameter and an increased persistent systolic pressure gradient were associated with encountering abnormal follow-up imaging studies. Aortic wall abnormalities included dissections ( n = 5) and aneurysm ( n = 13). The risk of encountering aortic wall abnormalities increased with larger percent increase in CoA diameter poststent implant, increasing balloon/coarc ratio, and performing prestent angioplasty. Stent restenosis was observed in 5/6 parts encountering stent fracture and neointimal buildup ( n = 16). Small CoA diameter poststent implant and increased poststent residual pressure gradient increased the likelihood of encountering instent restenosis at intermediate follow-up. Conclusions : Abnormalities were observed at intermediate follow-up following IS placement for treatment of native and recurrent coarctation of the aorta. Not exceeding a balloon:coarctation ratio of 3.5 and avoidance of prestent angioplasty decreased the likelihood of encountering an abnormal follow-up imaging study in patients undergoing intravascular stent placement for the treatment of coarctation of the aorta. We r

Published
2007

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