Korean Circ J.  2012 Oct;42(10):652-656. 10.4070/kcj.2012.42.10.652.

Percutaneous Pulmonary Valve Implantation

• Lee YS
• Lee HD

• KMID: 1826460
• DOI: http://doi.org/10.4070/kcj.2012.42.10.652

Abstract

Pulmonary regurgitation (PR) is a frequent sequelae after repair of tetralogy of Fallot, pulmonary atresia, truncus arteriosus, Rastelli and Ross operation. Due to patient growth and conduit degeneration, these conduits have to be changed frequently due to regurgitation or stenosis. However, morbidity is significant in these repeated operations. To prolong conduit longevity, bare-metal stenting in the right ventricular outflow tract (RVOT) obstruction has been performed. Stenting the RVOT can reduce the right ventricular pressure and symptomatic improvement, but it causes PR with detrimental effects on the right ventricle function and risks of arrhythmia. Percutaneous pulmonary valve implantation has been shown to be a safe and effective treatment for patients with pulmonary valve insufficiency, or stenotic RVOTs.

Keyword

Catheterization; Pulmonary valve

MeSH Terms

Arrhythmias, Cardiac
Catheterization
Constriction, Pathologic
Heart Ventricles
Humans
Longevity
Pulmonary Atresia
Pulmonary Valve
Pulmonary Valve Insufficiency
Stents
Tetralogy of Fallot
Truncus Arteriosus
Ventricular Pressure

Figure

• 

  Fig. 1 Melody® transcatheter pulmonary valve and Ensemble® valve delivery system.

Reference

1. Bonhoeffer P, Boudjemline Y, Saliba Z, et al. Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet. 2000; 356:1403–1405. PMID: 11052583.

2. Bonhoeffer P, Boudjemline Y, Saliba Z, et al. Transcatheter implantation of a bovine valve in pulmonary position: a lamb study. Circulation. 2000; 102:813–816. PMID: 10942752.

3. Bonhoeffer P, Boudjemline Y, Qureshi SA, et al. Percutaneous insertion of the pulmonary valve. J Am Coll Cardiol. 2002; 39:1664–1669. PMID: 12020495.

4. Lauten A, Hoyme M, Figulla HR. Severe pulmonary regurgitation after tetralogy-of-Fallot repair: transcatheter treatment with the Edwards SAPIEN XT heart valve. Heart. 2012; 98:623–624. PMID: 22373721.

5. Kenny D, Hijazi ZM, Kar S, et al. Percutaneous implantation of the Edwards SAPIEN transcatheter heart valve for conduit failure in the pulmonary position: early phase 1 results from an international multicenter clinical trial. J Am Coll Cardiol. 2011; 58:2248–2256. PMID: 22078433.

6. Boone RH, Webb JG, Horlick E, et al. Transcatheter pulmonary valve implantation using the Edwards SAPIEN transcatheter heart valve. Catheter Cardiovasc Interv. 2010; 75:286–294. PMID: 19924775.

7. Marianeschi SM, Santoro F, Ribera E, et al. Pulmonary valve implantation with the new Shelhigh Injectable Stented Pulmonic Valve. Ann Thorac Surg. 2008; 86:1466–1471. discussion 1472. PMID: 19049732.

8. Garay F, Webb J, Hijazi ZM. Percutaneous replacement of pulmonary valve using the Edwards-Cribier percutaneous heart valve: first report in a human patient. Catheter Cardiovasc Interv. 2006; 67:659–662. PMID: 16586515.

9. Therrien J, Provost Y, Merchant N, Williams W, Colman J, Webb G. Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. Am J Cardiol. 2005; 95:779–782. PMID: 15757612.

10. Batra AS, McElhinney DB, Wang W, et al. Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial. Am Heart J. 2012; 163:280–287. PMID: 22305848.

11. Lurz P, Nordmeyer J, Giardini A, et al. Early versus late functional outcome after successful percutaneous pulmonary valve implantation: are the acute effects of altered right ventricular loading all we can expect? J Am Coll Cardiol. 2011; 57:724–731. PMID: 21292132.

12. Eicken A, Ewert P, Hager A, et al. Percutaneous pulmonary valve implantation: two-centre experience with more than 100 patients. Eur Heart J. 2011; 32:1260–1265. PMID: 21273201.

13. Peng LF, McElhinney DB, Nugent AW, et al. Endovascular stenting of obstructed right ventricle-to-pulmonary artery conduits: a 15-year experience. Circulation. 2006; 113:2598–2605. PMID: 16735676.

14. Khambadkone S, Bonhoeffer P. Nonsurgical pulmonary valve replacement: why, when, and how? Catheter Cardiovasc Interv. 2004; 62:401–408. PMID: 15224313.

15. Khambadkone S. Percutaneous pulmonary valve implantation. Ann Pediatr Cardiol. 2012; 5:53–60. PMID: 22529604.

16. Nordmeyer J, Khambadkone S, Coats L, et al. Risk stratification, systematic classification, and anticipatory management strategies for stent fracture after percutaneous pulmonary valve implantation. Circulation. 2007; 115:1392–1397. PMID: 17339542.

17. Zahn EM, Hellenbrand WE, Lock JE, McElhinney DB. Implantation of the melody transcatheter pulmonary valve in patients with a dysfunctional right ventricular outflow tract conduit early results from the u.s. Clinical trial. J Am Coll Cardiol. 2009; 54:1722–1729. PMID: 19850214.

18. Demkow M, Biernacka EK, Spiewak M, et al. Percutaneous pulmonary valve implantation preceded by routine prestenting with a bare metal stent. Catheter Cardiovasc Interv. 2011; 77:381–389. PMID: 20602475.

19. Nordmeyer J, Lurz P, Khambadkone S, et al. Pre-stenting with a bare metal stent before percutaneous pulmonary valve implantation: acute and 1-year outcomes. Heart. 2011; 97:118–123. PMID: 20965979.

20. Momenah TS, El Oakley R, Al Najashi K, Khoshhal S, Al Qethamy H, Bonhoeffer P. Extended application of percutaneous pulmonary valve implantation. J Am Coll Cardiol. 2009; 53:1859–1863. PMID: 19442885.

21. Lurz P, Nordmeyer J, Muthurangu V, et al. Comparison of bare metal stenting and percutaneous pulmonary valve implantation for treatment of right ventricular outflow tract obstruction: use of an x-ray/magnetic resonance hybrid laboratory for acute physiological assessment. Circulation. 2009; 119:2995–3001. PMID: 19487596.

22. Cubeddu RJ, Hijazi ZM. Bailout perventricular pulmonary valve implantation following failed percutaneous attempt using the Edwards Sapien transcatheter heart valve. Catheter Cardiovasc Interv. 2011; 77:276–280. PMID: 20518008.

23. McElhinney DB, Hellenbrand WE, Zahn EM, et al. Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation. 2010; 122:507–516. PMID: 20644013.

24. Sridharan S, Coats L, Khambadkone S, Taylor AM, Bonhoeffer P. Images in cardiovascular medicine. Transcatheter right ventricular outflow tract intervention: the risk to the coronary circulation. Circulation. 2006; 113:e934–e935. PMID: 16801469.

25. Biermann D, Schönebeck J, Rebel M, Weil J, Dodge-Khatami A. Left coronary artery occlusion after percutaneous pulmonary valve implantation. Ann Thorac Surg. 2012; 94:e7–e9. PMID: 22735024.

26. Lurz P, Coats L, Khambadkone S, et al. Percutaneous pulmonary valve implantation: impact of evolving technology and learning curve on clinical outcome. Circulation. 2008; 117:1964–1972. PMID: 18391109.

27. Nordmeyer J, Coats L, Lurz P, et al. Percutaneous pulmonary valve-invalve implantation: a successful treatment concept for early device failure. Eur Heart J. 2008; 29:810–815. PMID: 18316357.

28. Vezmar M, Chaturvedi R, Lee KJ, et al. Percutaneous pulmonary valve implantation in the young 2-year follow-up. JACC Cardiovasc Interv. 2010; 3:439–448. PMID: 20398873.

29. Khambadkone S, Coats L, Taylor A, et al. Percutaneous pulmonary valve implantation in humans: results in 59 consecutive patients. Circulation. 2005; 112:1189–1197. PMID: 16103239.

30. McElhinney DB, Cheatham JP, Jones TK, et al. Stent fracture, valve dysfunction, and right ventricular outflow tract reintervention after transcatheter pulmonary valve implantation: patient-related and procedural risk factors in the US Melody Valve Trial. Circ Cardiovasc Interv. 2011; 4:602–614. PMID: 22075927.