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Leaflet morphology classification of the Melody Transcatheter Pulmonary Valve

机译：旋律经导管肺瓣的瓣叶形态分类

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Abstract Objective We sought to describe the leaflet morphology variation in the Melody Transcatheter Pulmonary Valve (TPV) and evaluate associated outcomes. The Melody TPV is constructed from harvested bovine jugular venous valves which have been rigorously tested. Natural anatomic leaflet variations are seen in the Melody TPV but have not been evaluated. Design A Melody TPV leaflet morphology classification system was devised after reviewing a subset of photographed and implanted TPVs. All images were blindly reviewed by implanters and classified. Midterm hemodynamic outcomes and complications of the Melody TPVs were compared by leaflet morphology. Results Photographed Melody TPVs implanted between 2011 and 2016 (n = 62) were categorized into the following leaflet morphology types: A—symmetric trileaflet (47%); B—asymmetric trileaflet with a single small leaflet (32%); C—asymmetric trileaflet with a single large leaflet (16%); D—rudimentary leaflet with near bicuspid appearance (5%). Acceptable hemodynamic function at 6 months postimplantation was seen in 97.5% of valves. Over a median follow‐up of 1.5 years (range 0‐4.4 years), two TPVs (Type A) had mild regurgitation. Nine TPVs developed complications (endocarditis, 3; stent fracture, 2; refractory arrhythmia, 1; conduit replacement, 2; death, 1), of which 6 required reintervention. There was no significant difference in outcomes based on Melody TPV leaflet morphology type. Conclusions The Melody TPV can be classified into one of four categories based on leaflet morphology. Study outcomes were not associated with leaflet morphology. Further documentation and evaluation of Melody TPV morphology may lead to better understanding of this technology.
机译：摘要目的我们寻求描述旋律经导管肺瓣膜（TPV）中的传单形态变化，并评估相关的结果。熔融TPV由已收获的牛颈静脉阀构成，该静脉阀已经严格地测试。在旋律TPV中可以看到自然解剖鳄鱼变异，但尚未得到评估。设计旋律TPV宣传片形态分类系统是在审查拍摄和植入的TPV的子集之后。所有图像都被植入机呼吁审查并分类。通过传单形态进行比较MENTERM血液动力学结果和旋律TPV的并发症。结果拍摄的旋律TPV在2011和2016（n = 62）之间植入于以下宣传叶形态类型：A-Commetric Tri器（47％）; B-不对称三叶叶，单个小瓣叶（32％）; C-不对称三叶叶，具有单个大瓣叶（16％）; D-Rudatiantary宣传叶与双囊外观（5％）。在97.5％的阀门中看到了6个月后可接受的血液动力学功能。在1.5年（0-4.4岁范围）的中位随访中，两个TPV（A型）有＆GT;轻度反流。九种TPVs开发了并发症（心内膜炎，3;支架骨折，2;难治性心律失常，1;导管替代，2;死亡，1），其中6个被要求重新实施。基于旋律TPV传单形态类型的结果没有显着差异。结论旋律TPV可以分为基于传单形态的四个类别之一。研究结果与传单形态无关。进一步的文献和对旋律TPV形态的评价可能导致更好地了解这项技术。

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