title: Hybrid Approach for Off-Pump Pulmonary Valve Replacement in Patients With a Dilated Right Ventricular Outflow Tract.
abstract: We describe a hybrid method for minimally invasive pulmonary valve replacement without the use of cardiopulmonary bypass in 3 patients with high surgical risk and dilated right ventricular outflow tracts incompatible with currently available transcatheter devices. This procedure entails surgical creation of a landing zone in the main pulmonary artery through an anterior thoracotomy, followed by transcatheter Melody valve pulmonary valve replacement. Particularly in high-risk patients, this approach may limit morbidity and mortality associated with traditional surgical pulmonary valve replacement.
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: diego.porras@cardio.chboston.org.
authors.forename: Diego
authors.initials: D
authors.lastname: Porras
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Michelle
authors.initials: M
authors.lastname: Gurvitz
authors.affiliation: Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Audrey C
authors.initials: AC
authors.lastname: Marshall
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Sitaram M
authors.initials: SM
authors.lastname: Emani
mesh_terms: D000293:Adolescent; D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013908:Thoracotomy / Q000379:methods*; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*