Balloon-Expandable Pulmonary Valves for Patched or Native Right Ventricular Outflow Tracts

• Published in: Pediatric cardiology Vol. 44; no. 6; pp. 1285 - 1292
• Main Authors: Álvarez-Fuente, M., Toledano, M., Garrido-Lestache, E., Sánchez, I., Molina, I., Rivero, N., García-Ormazábal, I., del Cerro, M. J.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-08-2023; Springer
• Subjects: Cardiac Catheterization - methods; Cardiac Surgery; Cardiology; Congenital heart disease; Genetic disorders; Heart Defects, Congenital - surgery; Heart diseases; Heart Valve Prosthesis - adverse effects; Heart Valve Prosthesis Implantation - methods; Humans; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Prosthesis Design; Pulmonary Valve - surgery; Pulmonary Valve Insufficiency; Retrospective Studies; Treatment Outcome; Vascular Surgery; Tetralogy of Fallot; Balloon-expandable valves; Congenital heart disease; Percutaneous pulmonary valve implantation; Anchoring technique
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-023-03173-2

The implantation of percutaneous balloon expandable valves in native or patched right ventricular outflow tracts (nRVOT) is a challenging technique due to the diversity of anatomies and shapes, the large sizes, and the distensibility of the nRVOT, for which specific techniques have been developed. We present a single center experience with balloon expandable percutaneous pulmonary valves in nRVOT, describing the techniques used, complications observed, and a short-mid term follow-up.. This is a single center descriptive study of patients who underwent a percutaneous pulmonary valve implantation in a nRVOT with a balloon expandable pulmonary valve in our center between September 2012 and June 2022.. We implanted successfully 45 valves in 46 patients (20 Sapien and 25 Melody). Tetralogy of Fallot or pulmonary atresia with VSD were the main congenital heart disease (
n
 = 32). All were pre-stented, 18 in a one step procedure. We used a Dryseal sheath in 13/21 Sapien. In 6 patients we used the anchoring technique, 5 with a very large nRVOT and one pyramidal nRVOT. In the 3.5 year follow-up 7 patients developed endocarditis and 3 required a valve redilation, no fractures were observed. PPVI of native RVOT with balloon expandable valves is feasible in a number of selected anatomies, including large or pyramidal nRVOT, using specific techniques, (presenting, LPA anchoring).