Transcatheter Pulmonary Valve Replacement: Current State of Art

Alkashkari, Wail; Alsubei, Amani; Hijazi, Ziyad M.

doi:10.1007/s11886-018-0966-y

Cited by 35 publications

(34 citation statements)

References 75 publications

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“…Our observations confirm previous studies that showed a reduction of TR in even 65% of patients over 5 years of follow-up [13,14]. We agree with Alkashkari et al that these observations will lead to the extension of indications for TPVI [5].…”

Section: Early Resultssupporting

confidence: 93%

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Transcatheter pulmonary valve implantation in 100 patients: a 10-year single-center experience

Rużyłło

Biernacka

Woźniak

et al. 2020

pwki

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Introduction: Transcatheter pulmonary valve implantation (TPVI) is a non-surgical method of treatment for patients with right ventricular outflow tract (RVOT) dysfunction after surgical repair of congenital heart defects (CHD). Aim: To evaluate the long-term results of TPVI performed in a single center. Material and methods: Over 10 years, TPVI was performed in 100 patients (mean age: 26.4 ±8.1 years), using Melody Medtronic or Sapien Edwards valves. Results: The initial success rate of TPVI was 93%. In 7 cases (5 urgent), a switch to surgical intervention was necessary due to periprocedural complications (all patients survived). Following TPVI, none of the 93 patients had severe pulmonary regurgitation. The pulmonary gradient decreased from 49.0 ±37.8 before to 27.6 ±14.9 mm Hg directly after TPVI (p < 0.0001). Right ventricular end-diastolic volume decreased, while NYHA class and pVO 2 uptake significantly improved in 1 year after TPVI. Freedom from reintervention was 100% in 1 year. Freedom from serious adverse events was 86% in mean 5.5 years of observation. The main reason for reintervention was infective endocarditis (IE) (1.6% patients/year). Increased risk of IE was associated with severe PS before valve implantation and the suboptimal result of TPVI. The incidence of IE seems to be lower in patients treated permanently with antiplatelet therapy (1.8% vs. 0.9% patients/year, NS). Conclusions: TPVI is a safe and effective method of treatment in patients with RVOT dysfunction after surgical correction of CHD. To achieve a good outcome, precise patient selection and rigorous IE prevention are necessary.

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Section: Early Resultssupporting

confidence: 93%

“…Procedural success was achieved in 93% with no mortality. In other studies, the procedural success rate was similar or slightly better (95%), but with mortality of 1.5 (0.8-2.6)% [4,5]. Freedom from reintervention, surgery, or endocarditis in our group was 99% in 1 year and 85.8% in mean 5.5 years of observation after TPVI.…”

Section: Discussionsupporting

confidence: 68%

Transcatheter pulmonary valve implantation in 100 patients: a 10-year single-center experience

Rużyłło

Biernacka

Woźniak

et al. 2020

pwki

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“…1 The procedure is now widely accepted as an option for RVOT dysfunction. 2,3 The Sapien valve series (Edwards Lifesciences, Irvine, CA), including the second-generation Sapien XT valve and the third-generation Sapien 3 (S3) valve, was initially developed for transcatheter aortic valve implantation (TAVI) and are now also commonly used for TPVI.…”

Section: Introductionmentioning

confidence: 99%

“…Since Bonhoeffer et al demonstrated the first successful transcatheter pulmonary valve implantation (TPVI) for a patient with insufficiency of a right ventricular outflow tract (RVOT) conduit in 2001, the device technologies and delivery techniques have continually been refined to improve their performance 1 . The procedure is now widely accepted as an option for RVOT dysfunction 2,3 …”

Section: Introductionmentioning

confidence: 99%

Utility of the long DrySeal sheath in facilitating transcatheter pulmonary valve implantation with the Edwards Sapien 3 valve

Fukuda¹,

Tan²,

Sadeghi³

et al. 2020

Cathet Cardio Intervent

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Objective: To assess the utility of the 65-cm-long Gore DrySeal sheath when compared to the standard 36-cm-long Edwards expandable sheath (e-sheath) for transcatheter pulmonary valve implantation (TPVI) with the Edwards Sapien 3 valve. Methods: All patients who underwent TPVI with the Sapien 3 valve, excluding those performed via hybrid approach, at our center between September 2015 and November 2019 were retrospectively reviewed and compared between two groups. Results: A total of 94 patients were enrolled; 29 patients underwent TPVI with the Sapien valve using the DrySeal sheath and 65 underwent TPVI using the e-sheath. The height and body weight of patients implanted using the DrySeal sheath ranged from 137 to 193 cm and from 33 to 129 kg, respectively. Valve delivery time was significantly shorter in the DrySeal group (median time 4 min 33 s vs. 9 min 6 s, p = .002). There were no complications in the DrySeal group (0/27). Nine procedural complications occurred in the e-sheath group (9/65), five of which were potentially directly related to sheath choice, including tricuspid valve injury in four and embolization of the tip of the e-sheath during retrieval of a ruptured balloon in one patient. Conclusions: TPVI with the Sapien 3 valve using the 65-cm-long DrySeal sheath facilitates faster and safer valve implantation when compared to the e-sheath.

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“…Transcatheter pulmonary valve replacement (TPVR) represents a valid option treatment for patients suffering from valvular heart diseases. 1 Current clinically approved heart valve substitutes for TPVR consist of glutaraldehyde-fixed animal-derived materials (e.g., bovine and porcine pericardium and porcine heart valves). 2 Owing to their animal origin, such substitutes are prone to progressive structural degradation and calcific degeneration, thus requiring multiple substitutive re-interventions, which are particularly critical for young patients.…”

Section: Introductionmentioning

confidence: 99%

Human cell-derived tissue-engineered heart valve with integrated Valsalva sinuses: towards native-like transcatheter pulmonary valve replacements

et al. 2019

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Transcatheter valve replacement indication is currently being extended to younger and lower-risk patients. However, transcatheter prostheses are still based on glutaraldehyde-fixed xenogeneic materials. Hence, they are prone to calcification and long-term structural degeneration, which are particularly accelerated in younger patients. Tissue-engineered heart valves based on decellularized in vitro grown tissue-engineered matrices (TEM) have been suggested as a valid alternative to currently used bioprostheses, showing good performance and remodeling capacity as transcatheter pulmonary valve replacement (TPVR) in sheep. Here, we first describe the in vitro development of human cell-derived TEM (hTEM) and their application as tissue-engineered sinus valves (hTESVs), endowed with Valsalva sinuses for TPVR. The hTEM and hTESVs were systematically characterized in vitro by histology, immunofluorescence, and biochemical analyses, before they were evaluated in a pulse duplicator system under physiological pulmonary pressure conditions. Thereafter, transapical delivery of hTESVs was tested for feasibility and safety in a translational sheep model, achieving good valve performance and early cellular infiltration. This study demonstrates the principal feasibility of clinically relevant hTEM to manufacture hTESVs for TPVR.

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Transcatheter Pulmonary Valve Replacement: Current State of Art

Cited by 35 publications

References 75 publications

Transcatheter pulmonary valve implantation in 100 patients: a 10-year single-center experience

Transcatheter pulmonary valve implantation in 100 patients: a 10-year single-center experience

Utility of the long DrySeal sheath in facilitating transcatheter pulmonary valve implantation with the Edwards Sapien 3 valve

Human cell-derived tissue-engineered heart valve with integrated Valsalva sinuses: towards native-like transcatheter pulmonary valve replacements

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