title: Management of a dissection of matrix P right ventricular-to-pulmonary artery conduit by implanting two pre-stents and a melody valve.
abstract: Reconstructing the right ventricular outflow tract and pulmonary valve via a bovine-derived valve conduit such as Matrix-P-Xenograft is a common surgical repair technique for pulmonary atresia and ventricular septal defect. After conduit degeneration due to calcification or aneurysmal dilatation, percutaneous transvenous stenting of the right ventricular outflow tract followed by pulmonary valve implantation has become the standard interventional treatment. Applied to stenotic conduits, the method is considered safe and effective. An important but seldom-reported problem is graft failure related to the formation of a Matrix membrane due to inflammation and fibrosis inside the xenograft, which can cause serious problems when dissection and rupture occur during transcatheter intervention. The torn pseudomembrane may cause the complete obstruction of both pulmonary arteries, resulting in a life-threatening situation requiring rapid intervention, as in this case presentation. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Congenital Heart Defects and Pediatric Cardiology, Heart Centre, University of Freiburg, Freiburg, Germany.
authors.forename: Joanna
authors.initials: J
authors.lastname: Nozynska
authors.affiliation: Department of Congenital Heart Defects and Pediatric Cardiology, Heart Centre, University of Freiburg, Freiburg, Germany.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Stiller
authors.affiliation: Department of Congenital Heart Defects and Pediatric Cardiology, Heart Centre, University of Freiburg, Freiburg, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Grohmann
mesh_terms: D001705:Bioprosthesis; D002648:Child; D018618:Echocardiography, Doppler, Color; D006343:Heart Septal Defects / Q000503:physiopathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D064593:Heterografts; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D018633:Pulmonary Atresia / Q000503:physiopathology / Q000601:surgery*; D011664:Pulmonary Valve / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D015641:Radiography, Interventional; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome
keywords: congenital heart disease; matrix P plus conduit; minimally invasive revalvulation; percutaneous pulmonary valve implantation; pulmonary valve replacement; right ventricular outflow tract dysfunction