{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T09:05:00Z","timestamp":1770714300758,"version":"3.49.0"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Alterra adaptive prestent is a novel self\u2010expanding device designed to provide a landing zone for the 29\u2009mm SAPIEN 3 valve to treat pulmonary regurgitation in patients with a right ventricular outflow tract that is too large for a balloon expandable valve alone. The mechanism of fixation for the Alterra prestent is radial force from the self\u2010expanding stent frame, combined with a unique set of flared \u201ctines\u201d that protrude from both ends of the stent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims, Methods, and Results<\/jats:title><jats:p>In this report, we describe 6\u00a0patients who underwent uncomplicated transcatheter pulmonary valve replacement with an Alterra adaptive prestent and SAPIEN 3 valve and had surveillance chest computed tomography (CT) scans performed 1 day to 21 months after implant. In each patient, the CT scan demonstrated extravascular extension of a portion of the Alterra prestent, without clinical sequelae, but with extension into the ascending aorta in 1 patient and contact with the ascending aorta, left pulmonary vein, or left atrial appendage\u00a0in 3 others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surveillance CT imaging shows that the Alterra prestent can perforate the pulmonary artery and\/or right ventricle. Although no sequelae were seen in these patients, prestent perforation has the potential to be clinically important. Implanters should be aware of this finding and its potential implications. As experience with the Alterra prestent grows, it will be important to further define the risk factors, incidence, and implications of this phenomenon.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31147","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T06:50:32Z","timestamp":1720162232000},"page":"256-263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Extravascular protrusion of the Alterra adaptive prestent identified on surveillance computed tomography imaging"],"prefix":"10.1002","volume":"104","author":[{"given":"Matthew J.","family":"Gillespie","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, The Children's Hospital of Philadelphia University of Pennsylvania School of Medicine Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-3658","authenticated-orcid":false,"given":"Nicola","family":"Maschietto","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamil A.","family":"Aboulhosn","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Mattel Children's Hospital at UCLA Ahmanson\/UCLA Adult Congenital Heart Disease Center Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David T.","family":"Balzer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5992-568X","authenticated-orcid":false,"given":"Athar M.","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Texas Children's Hospital and Department of Pediatrics Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7242-0934","authenticated-orcid":false,"given":"Doff B.","family":"McElhinney","sequence":"additional","affiliation":[{"name":"Departments of Cardiothoracic Surgery and Pediatrics (Cardiology) Stanford University School of Medicine Palo Alto California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.06.039"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27581"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.019987"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28596"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.068"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21945"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.04.053"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.07.046"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.01.007"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.112.000073"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.31147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T12:02:34Z","timestamp":1756987354000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.31147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,5]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/ccd.31147"],"URL":"https:\/\/doi.org\/10.1002\/ccd.31147","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,5]]},"assertion":[{"value":"2024-04-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}