Transcatheter pulmonary valve insertion: when, how, and why

Abstract

Transcatheter pulmonary valve replacement is fast becoming an accepted alternative to repeat surgical pulmonary valve replacement for selected patients and therefore a complementary strategy in the long-term management of those requiring surgical pulmonary valve replacement. With a combined surgical and percutaneous approach, late morbidity for some of these patients may be diminished. This manuscript will review the current indications for this procedure, its limitations, and its benefits.

Evaluation of Hybrid Surgical Access Approaches for Pulmonary Valve Implantation in an Acute Swine Model

“…7,9,15 Thus, these patients need many reoperations, 27 and every reoperation is associated with an increased risk of cardiac damage due to resternotomy, harmful bleeding, infection, and myocardial or neurologic injury from cardiopulmonary bypass. 27,36 Consequently, the correct timing of pulmonary valve replacement is of particular importance: soon enough to prevent right ventricular damage but late enough to keep reoperation rates low. 35 In 2000, a new, less invasive technique 9 to prolong conduit lifespan and to treat valve stenosis or regurgitation was published: 32 a bovine jugular valve sutured into a platinum stent is implanted into the pulmonary valve position through percutaneous access of the femoral vein.…”

Transcatheter Aortic Valve Replacement in a Young Adult Patient with a Failed Homograft

“…An important goal in patients with congenital valvular disease is minimization of the lifetime cumulative morbidity from repeated surgery which potentially improves the life expectancy of patients [11]. The dilemma of when to treat patients with recurrent valvular disease is one that faces all cardiologists and cardiac surgeons.…”

“…The dilemma of when to treat patients with recurrent valvular disease is one that faces all cardiologists and cardiac surgeons. Historically, in patients with right ventricular outflow dysfunction, hesitancy to surgically replace the pulmonary valve resulted in irreversible right ventricular dysfunction [11][12][13].…”

Transcatheter pulmonary valve insertion, expanded use and future directions

“…8,9 Previously, we discussed the basics regarding insertion of the Melody s valve. 10 In this paper, we intend, through multiple case presentations, to demonstrate expanded applications and discuss future directions for this evolving technology.…”