Transcatheter Versus Surgical Pulmonary Valve Replacement: A Systemic Review and Meta-Analysis

Ribeiro, Joana Maria; Teixeira, Rogério; Lopes, João; Costa, Marco; Pires, António; Gonçalves, Lino

doi:10.1016/j.athoracsur.2020.03.007

Cited by 37 publications

(34 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 1 ] Percutaneous valves are an alternative to surgery for narrowing or regurgitation of the outflow tracts when these patients need a pulmonary valve replacement. [ 2 3 ] Melody valve (Medtronic Inc., Minneapolis, MN) has limited utility in native outflow tracts. [ 4 ] Outflows with transannular patches have varied morphology and need a different approach.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Venus P-valve for dysfunctional right ventricular outflow tracts from Indian Venus P-valve database

Sivakumar

Sagar

Qureshi

et al. 2021

Annals of Pediatric Cardiology

View full text Add to dashboard Cite

Background : Balloon-expandable pulmonary valves are usually not suitable for dilated native outflow tracts. Methods : Indian Venus P-valve registry was retrospectively analyzed for efficacy, complications, and midterm outcomes. Straight valve was used in prestented conduits in patients with right ventricular pressure above two-thirds systemic pressure and/or right ventricular dysfunction. Flared valve 1–4 mm larger than balloon waist was used in native outflow in symptomatic patients, large ventricular volumes, and ventricular dysfunction. Objectives : A self-expanding porcine pericardial Venus P-valve is available in straight and flared designs.. Results : Twenty-nine patients were included. Straight valve was successful in all seven conduits, reducing gradients significantly, including one patient with left pulmonary artery (LPA) stent. Flared valve was successfully implanted in 20 out of 22 native outflow tracts. Sharp edges of the older design contributed to two failures. Complications included two migrations with one needing surgery, endocarditis in one, insignificant wire-frame fractures in three, and groin vascular complication in one patient. There were no deaths or valve-related reinterventions at a mean follow-up of 47.8 ± 24.5 months (1–85 months). Modifications of technique succeeded in three patients with narrow LPA. There was significant improvement in symptoms, right ventricular volume, and pulmonary regurgitant fraction. Conclusion : Straight and flared Venus P-valves are safe and effective in appropriate outflow tracts. Straight valve is an alternative to balloon-expandable valves in stenosed conduits. Flared valve is suitable for large outflows up to 34 mm, including patients with LPA stenosis. Recent design modifications may correct previous technical failures. Studies should focus on durability and late complications.

show abstract

Section: Introductionmentioning

confidence: 99%

Outcomes of Venus P-valve for dysfunctional right ventricular outflow tracts from Indian Venus P-valve database

Sivakumar

Sagar

Qureshi

et al. 2021

Annals of Pediatric Cardiology

View full text Add to dashboard Cite

show abstract

“…[ 155,156 ] Despite the shortcomings, Pt–Ir such as the Melody valve from Medtronic is still being used as a stent for TAV applications. [ 157 ]…”

Section: Materials Used For Thvsmentioning

confidence: 99%

“…[ 211 ] Unfortunately, common complications include those often found with off‐label use for pediatrics, such as valve dislodgement, stent fracturing, recurrent stenosis, and regurgitation. [ 149,156,157b ] These problems may be rectified by redesigning the current commercial transcatheter valves and tailoring them toward the needs of the younger population. The recent development of expandable prosthetic valves to allow somatic growth for pediatric patients may spark interest in the transcatheter deployment of these novel pediatric valves, whose designs are strikingly similar to THVs.…”

Section: Current Trends and Future Directionsmentioning

confidence: 99%

“…[ 3 ] Transcatheter pulmonary valve replacement (TPVR) was also demonstrated to be a safe alternative to surgical valve placement. [ 4 ] Unsurprisingly, THVR is a growing field, and the number of cases is forecasted to grow substantially in the coming years. For example, TAVR saw a remarkable annual surge (between 400% and 500%) from 2012 to 2019.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transcatheter Heart Valves: A Biomaterials Perspective

Bui

Khair

Yeats

et al. 2021

Adv Healthcare Materials

View full text Add to dashboard Cite

Heart valve disease is prevalent throughout the world, and the number of heart valve replacements is expected to increase rapidly in the coming years. Transcatheter heart valve replacement (THVR) provides a safe and minimally invasive means for heart valve replacement in high‐risk patients. The latest clinical data demonstrates that THVR is a practical solution for low‐risk patients. Despite these promising results, there is no long‐term (>20 years) durability data on transcatheter heart valves (THVs), raising concerns about material degeneration and long‐term performance. This review presents a detailed account of the materials development for THVRs. It provides a brief overview of THVR, the native valve properties, the criteria for an ideal THV, and how these devices are tested. A comprehensive review of materials and their applications in THVR, including how these materials are fabricated, prepared, and assembled into THVs is presented, followed by a discussion of current and future THVR biomaterial trends. The field of THVR is proliferating, and this review serves as a guide for understanding the development of THVs from a materials science and engineering perspective.

show abstract

“…A recent meta-analysis of 1132 TPVI and 4939 SPVR patients also did not show any difference in mortality or repeat interventions. However, there were fewer procedure related complications and higher rate of endocarditis with TPVI[ 43 ]. A study using the Nationwide Inpatient Sample database also suggested the same–comparing an estimated 8449 SPVR and 555 TPVI admissions, it showed a higher in-hospital mortality with SPVR along with other iatrogenic cardiac complications.…”

Section: Outcomes Of Tpvimentioning

confidence: 99%

Transcatheter pulmonic valve implantation: Techniques, current roles, and future implications

Law¹,

Chatterjee²

2021

WJC

View full text Add to dashboard Cite

Right ventricular outflow tract (RVOT) obstruction is present in a variety of congenital heart disease states including tetralogy of Fallot, pulmonary atresia/stenosis and other conotruncal abnormalities etc. After surgical repair, these patients develop RVOT residual abnormalities of pulmonic stenosis and/or insufficiency of their native outflow tract or right ventricle to pulmonary artery conduit. There are also sequelae of other surgeries like the Ross operation for aortic valve disease that lead to right ventricle to pulmonary artery conduit dysfunction. Surgical pulmonic valve replacement (SPVR) has been the mainstay for these patients and is considered standard of care. Transcatheter pulmonic valve implantation (TPVI) was first reported in 2000 and has made strides as a comparable alternative to SPVR, being approved in the United States in 2010. We provide a comprehensive review in this space–indications for TPVI, detailed procedural facets and up-to-date review of the literature regarding outcomes of TPVI. TPVI has been shown to have favorable medium-term outcomes free of re-interventions especially after the adoption of the practice of pre-stenting the RVOT. Procedural mortality and complications are uncommon. With more experience, recognition of risk of dreaded outcomes like coronary compression has improved. Also, conduit rupture is increasingly being managed with transcatheter tools. Questions over endocarditis risk still prevail in the TPVI population. Head-to-head comparisons to SPVR are still limited but available data suggests equivalence. We also discuss newer valve technologies that have limited data currently and may have more applicability for treatment of native dysfunctional RVOT substrates.

show abstract

Transcatheter Versus Surgical Pulmonary Valve Replacement: A Systemic Review and Meta-Analysis

Cited by 37 publications

References 47 publications

Outcomes of Venus P-valve for dysfunctional right ventricular outflow tracts from Indian Venus P-valve database

Outcomes of Venus P-valve for dysfunctional right ventricular outflow tracts from Indian Venus P-valve database

Transcatheter Heart Valves: A Biomaterials Perspective

Transcatheter pulmonic valve implantation: Techniques, current roles, and future implications

Contact Info

Product

Resources

About