Percutaneous Pulmonary Valve Implantation in Humans

Abstract

Background-Right ventricular outflow tract (RVOT) reconstruction with valved conduits in infancy and childhood leads to reintervention for pulmonary regurgitation and stenosis in later life. Methods and Results-Patients with pulmonary regurgitation with or without stenosis after repair of congenital heart disease had percutaneous pulmonary valve implantation (PPVI). Mortality, hemodynamic improvement, freedom from explantation, and subjective and objective changes in exercise tolerance were end points. PPVI was performed successfully in 58 patients, 32 male, with a median age of 16 years and median weight of 56 kg. The majority had a variant of tetralogy of Fallot (nϭ36), or transposition of the great arteries, ventricular septal defect with pulmonary stenosis (nϭ8

Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial

“…Transcatheter pulmonary valve (TPV) placement is a recent development that has been reported to provide a safe and effective nonsurgical alternative for the treatment of RVOT dysfunction in this patient population. [3][4][5] As TPV therapy becomes more widely adopted, it is important to assess the clinical and physiologic consequences of the procedure objectively and quantitatively. The hemodynamic benefits of TPV implantation have been previously reported.…”

Right ventricular outfl ow tract revalvulation using the Melody Valve: The next frontier

“…(7)(8)(9) Transthoracic echocardiography is used to determine right ventricular pressure load, size and categorical assessment of pulmonary regurgitation. However, echocardiographic right ventricular functional assessment does not correlate well with cardiac magnetic resonance imaging (MRI).…”

“…Cardiac MRI gathers valuable information regarding ventricle mass, function and volumes and is currently the preferred investigation. (7,8,13) …”

“…Major procedural complications included dislodgement of the valve, coronary compression, rupture of homograft and haemothorax due to pulmonary artery perforations. (7,(13)(14)(15)(16)(17)(18) Dislodgement of the device occurred mostly during the initial development phase and could be related to operator inexperience as well as the early learning curve. It is now extremely rare, especially with pre-stenting.…”

Virtual Pulmonary Valve Replacement Interventions with a Personalised Cardiac Electromechanical Model

“…Two PVR techniques are becoming prevalent. On the one hand, percutaneous PVR (PPVR) aims at inserting new pulmonary valves using minimally invasive methods [11]. However, this technique is only possible if the diameter of the right ventricle (RV) outflow tract is lower than 22 mm.…”