A5080991574- Congenital Heart Disease Studies
- Cardiac Structural Anomalies and Repair
- Cardiac Valve Diseases and Treatments
- Mechanical Circulatory Support Devices
- Pulmonary Hypertension Research and Treatments
- Cardiac Arrhythmias and Treatments
- Transplantation: Methods and Outcomes
- Cardiovascular Function and Risk Factors
- Infective Endocarditis Diagnosis and Management
- Cardiovascular and Diving-Related Complications
- Cardiac pacing and defibrillation studies
- Aortic Disease and Treatment Approaches
- Tracheal and airway disorders
- Cardiovascular Issues in Pregnancy
- Frailty in Older Adults
- Heart Failure Treatment and Management
- Congenital Diaphragmatic Hernia Studies
- Congenital heart defects research
- Atrial Fibrillation Management and Outcomes
- Cardiovascular Effects of Exercise
- Healthcare Systems and Technology
- Adolescent and Pediatric Healthcare
- Cardiomyopathy and Myosin Studies
- Coronary Artery Anomalies
- Renal and Vascular Pathologies
Newcastle University
2014-2024
Newcastle upon Tyne Hospitals NHS Foundation Trust
2012-2024
Freeman Hospital
2015-2024
University of Newcastle Australia
2014-2021
University of Oxford
2017
University College London
2005-2011
University College Hospital at Westmoreland Street
2005-2011
University College London Hospitals NHS Foundation Trust
2011
Wansbeck General Hospital
2010
Great Ormond Street Hospital
2005-2009
Background— Percutaneous pulmonary valve implantation was introduced in the year 2000 as a nonsurgical treatment for patients with right ventricular outflow tract dysfunction. Methods and Results— Between September February 2007, 155 stenosis and/or regurgitation underwent percutaneous implantation. This led to significant reduction systolic pressure (from 63±18 45±13 mm Hg, P <0.001) gradient 37±20 17±10 <0.001). Follow-up ranged from 0 83.7 months (median 28.4 months). Freedom...
Right ventricular outflow tract (RVOT) reconstruction with valved conduits in infancy and childhood leads to reintervention for pulmonary regurgitation stenosis later life.Patients or without after repair of congenital heart disease had percutaneous valve implantation (PPVI). Mortality, hemodynamic improvement, freedom from explantation, subjective objective changes exercise tolerance were end points. PPVI was performed successfully 58 patients, 32 male, a median age 16 years weight 56 kg....
Background— The timing of pulmonary valve replacement (PVR) for free incompetence in patients with congenital heart disease remains a dilemma clinicians. We wanted to assess the determinants improvement after PVR regurgitation over wide range patient ages and use any identified predictors compare clinical outcomes between groups. Methods Results— Seventy-one (mean age 22±11 years; range, 8.5 64.9; 72% tetralogy Fallot) underwent severe regurgitation. New York Heart Association class improved...
Purpose: To determine if magnetic resonance (MR) imaging data can be used to create rigid models that are accurate representations of the right ventricular outflow tract (RVOT) and pulmonary trunk anatomy such refine selection patients for percutaneous valve implantation (PPVI). Materials Methods: Institutional review board approval informed patient consent were obtained. Twelve patients' MR analyzed elaborated input into a rapid prototyping (RP) system. RP successfully built presented two...
We analyzed the incidence, risk factors and treatment options for stent fracture after percutaneous pulmonary valve (PPV) implantation (PPVI).After PPVI, 123 patients had chest x-ray in anteroposterior lateral projection, echocardiography, clinical evaluation during structured follow-up. Of these patients, 26 (21.1%) developed 0 to 843 days PPVI (stent fracture-free survival at 1 year, 85.1%; 2 years, 74.5%; 3 69.2%). Stent was classified as type I: no loss of integrity (n=17); II: with...
To present our experience of 'first-in-man' implantation a new percutaneous pulmonary valve into dilated trunk, using patient specific data to influence the design device and ensure safety.A 42-year-old with severe insufficiency underwent computed tomography assessment his trunk. This information was utilised create computer rapid prototyping models that were used customise test device, which subsequently implanted patient. Following procedure, clinical, haemodynamic morphological success...
Background— Right ventricular outflow tract obstruction (RVOTO) is a common problem after repair of congenital heart disease. Percutaneous pulmonary valve implantation (PPVI) can treat this condition without consequent regurgitation or cardiopulmonary bypass. Our aim was to investigate the clinical and physiological response relieving RVOTO. Methods Results— We studied 18 patients who underwent PPVI for RVOTO (72% male, median age 20 years) from total 93 had procedure various indications....
To investigate the early clinical and physiological consequences of relieving chronic right ventricular (RV) volume overload with percutaneous pulmonary valve implantation (PPVI).We selected 17 patients (age 21.2 +/- 8.7 years), from a total 125 who underwent PPVI, because they had important regurgitation (PR) [regurgitant fraction > 25% on magnetic resonance (MR)] an echocardiographic gradient < 50 mmHg across RV outflow tract. Cardiopulmonary exercise testing, tissue Doppler MR were...
Percutaneous pulmonary valve implantation (PPVI) is now an accepted treatment strategy for right ventricular (RV) outflow tract (RVOT) dysfunction in many European Heart Centres. We analysed the efficacy of repeat PPVI as a modality early device failure. Twenty patients underwent RVOT obstruction because failure ('Hammock effect', 'Hammock-like stent fracture, residual stenosis). Repeat was feasible all with no procedural complications. Following second device, catheter-measured gradient and...
<h3>Objective</h3> To estimate the size and characteristics of UK population with single-ventricle physiology, predict future growth. <h3>Methods</h3> The surviving physiology in Northern England (resident 2.9 million) was identified from our clinical database Congenital Abnormality Survey (NorCAS). Conditions included double inlet ventricle, tricuspid atresia, mitral hypoplastic left heart syndrome other unbalanced defects. Fetal diagnoses, terminations pregnancy surgical interventions were...
Objective: To assess the impact of a percutaneous technique for pulmonary valve implantation on conventional surgical valve/conduit approach to right ventricular outflow tract re-intervention. Methods: We have retrospectively reviewed our results following or re-intervention in both paediatric and adult groups. Between November 1998 March 2004, 94 patients underwent tract. Percutaneous was introduced October 2002 35 procedures were performed 2004. The median age 26 years (6–65 years) group...
Background: Pulmonary regurgitation after tetralogy of Fallot (ToF) repair is associated with right ventricular dilatation, failure and arrhythmia. Timing technique for re-intervention remain controversial. Methods: Our recent approach to reconstruct the dilated ventricle outflow tract (RVOT) as a fibro-muscular sleeve support pulmonary homograft valve conduit in orthotopic position. Indication based on clinical magnetic resonance (MR) criteria. We reviewed all patients who underwent RVOT...
The single ventricle patient population comprises the most complex cohort presenting to cardiac transplant team, in terms of demographics, anatomic substrate, and unique physiology. It is also rapidly growing diagnostic group for heart transplantation. In this manuscript, we aim describe changing landscape transplantation conditions through reflection on our own institution's practice experience, alongside contemporary literature review. Single patients are heterogeneous age, diagnosis...
Objectives Adults with congenital heart disease (ACHD) are a growing group end-stage failure. We aim to describe the outcomes of ACHD patients undergoing assessment for orthotopic transplant (OHT). Methods Case notes consecutive (>16 years) assessed OHT between 2000 and 2016 at our centre were reviewed. Decision outcome reported as 2017. Data analysed in three groups: systemic left ventricle (LV), right (RV) single (SV). Results 196 (31.8 years, 27% LV, 29% RV, 44% SV). 89 (45%) listed 67...
Background The population of women childbearing age palliated with a Fontan repair is increasing. aim this study was to describe the progress pregnancy and its outcome in cohort patients circulation UK. Methods A retrospective delivering between January 2005 November 2016 10 specialist adult congenital heart disease centres Results 50 had 124 pregnancies, resulting 68 (54.8%) miscarriages, 2 terminations pregnancy, 1 intrauterine death (at 30 weeks), 53 (42.7%) live births 4 neonatal deaths....
Objectives: To analyze factors responsible for stent fracture in percutaneous pulmonary valve implantation (PPVI) by finite element method. Background: PPVI is an interventional catheter‐based technique treating significant disease. Stent a recognized complication. Methods: Three different models were created: (1) platinum–10% iridium alloy – resembles the first‐generation device; (2) same geometry, but with addition of gold over strut intersections current stent; (3) design as 1, made...
The Ross procedure offers good autograft function and low reoperation rates for the neoaortic valve; however, rate of conduit dysfunction in right ventricular outflow tract remains a concern. This study assessed percutaneous pulmonary valve implantation this setting.We retrospectively analyzed outcomes 12 patients (mean age 28 +/- 5 years) referred to treat ventricle-pulmonary artery failure 11.1 3.3 years after procedure.Percutaneous was feasible all patients, with no procedural...
To bring together patients, parents, charities and clinicians in a Priority Setting Partnership to establish national clinical priorities for research children adults with congenital heart disease.The established James Lind Alliance methodology was used identify prioritise on the management of disease, focusing diagnosis, treatment outcomes. An initial open survey gather potential uncertainties which were filtered, categorised, converted into summary questions checked against current...