Percutaneous Pulmonary Valve Implantation With Balloon-Expandable Valves for Management of Dysfunctional Different Right Ventricular Outflow Tracts

IF 1.4 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of interventional cardiology Pub Date : 2026-06-26 DOI:10.1155/joic/9911295

Fatma Aboalsoud Taha, Mansour Almutairi, Reda Abuelatta

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引用次数: 0

Abstract

Introduction

Percutaneous pulmonary valve implantation (PPVI) has been approved for the management of the dysfunctional pulmonary valve (PV) and right ventricular outflow tract (RVOT). The study aimed to evaluate the feasibility, safety, and efficacy of the balloon-expandable valves in PPVI for the management of dysfunctional different RVOTs with pulmonary stenosis (PS) and/or pulmonary regurgitation (PR) and to compare PPVI between RV-PA conduits/bioprosthetic PVs and native/patched RVOTs regarding the preprocedure, procedural, postprocedural characteristics, and long-term outcome.

Methods

All patients who underwent PPVI for dysfunctional different RVOTs using balloon-expandable valves, either Melody or Sapien S3 valves, from May 2017 to January 2025 were included.

Results

Forty-two patients underwent PPVI; 24 (57.1%) had RV-PA conduits/bioprosthetic PVs, and 18 (42.9%) had native/patched RVOTs. The mean age and weight were 29.9 ± 13.7 years and 65.4 ± 23.6 kg, respectively. Cardiac MRI revealed the RVEDVI of 144.9 ± 32.9 mL/m², RVEF of 48.6 ± 7.1%, and PV-Pg of 33.5 ± 20.3 mmHg. Three (7.1%) patients with bioprosthetic PVs underwent direct valve implantation; 21 (50.0%) patients required 1 stent, 15 (35.7%) required 2 stents, and 2 (4.8%) from the native/patched RVOT group required the Russian Doll technique. The Melody valve was implanted in 7 (16.7%) patients, and the Edwards Sapien S3 valve was implanted in 35 (83.3%) patients. Larger balloons, longer and multiple stents, with larger valves were required in native/patched RVOTs (p < 0.001^∗). All patients reported technical success, with mean procedural and fluoroscopy times of 56.7 ± 6.9 and 37.8 ± 7.3 min. No patient suffered coronary impingement with a total in-hospital stay of 2.3 ± 1.0 days, without recorded mortality.

Conclusions

PPVI using balloon-expandable valves is a feasible and safe method for managing dysfunctional RVOTs: RV-PA conduits, bioprosthetic PVs, native, and patched RVOTs. However, preprocedural characteristics, procedural strategies, technical approaches, valve sizing methods, materials used, and outcomes vary according to the RVOT anatomy.

Abstract Image

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经皮球囊扩张瓣膜置入术治疗不同类型右心室流出道功能不全

经皮肺动脉瓣植入术（PPVI）已被批准用于治疗功能不全的肺动脉瓣（PV）和右心室流出道（RVOT）。本研究旨在评估可膨胀球囊瓣膜在PPVI中用于治疗功能不全的不同rvot（肺狭窄（PS）和/或肺返流（PR））的可行性、安全性和有效性，并比较RV-PA导管/生物假体pv和原生/修补rvot在术前、术中、术后特征和长期结果方面的PPVI。方法2017年5月至2025年1月，所有使用球囊可膨胀瓣膜（Melody或Sapien S3瓣膜）进行功能不全rvot PPVI的患者。结果42例患者行PPVI；24例（57.1%）有RV-PA导管/生物假体pv， 18例（42.9%）有原生/修补的rvot。平均年龄29.9±13.7岁，平均体重65.4±23.6 kg。心脏MRI显示RVEDVI为144.9±32.9 mL/m2， RVEF为48.6±7.1%，PV-Pg为33.5±20.3 mmHg。3例（7.1%）生物假体pv患者直接行瓣膜植入术；21例（50.0%）患者需要1个支架，15例（35.7%）患者需要2个支架，本地/修补RVOT组2例（4.8%）患者需要俄罗斯娃娃技术。7例（16.7%）患者植入Melody瓣膜，35例（83.3%）患者植入Edwards Sapien S3瓣膜。原生/修补的RVOTs需要更大的球囊、更长和多个支架、更大的瓣膜（p < 0.001∗）。所有患者均报告技术成功，平均手术和透视时间分别为56.7±6.9和37.8±7.3分钟。无冠状动脉梗塞患者，总住院时间2.3±1.0 d，无死亡记录。结论使用球囊膨胀阀进行PPVI治疗功能不全rvot是一种可行且安全的方法：RV-PA导管、生物假体pv、原生rvot和修补rvot。然而，手术前特征、手术策略、技术途径、瓣膜定径方法、使用的材料和结果因RVOT解剖而异。

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来源期刊

Journal of interventional cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including: Acute coronary syndrome Coronary disease Congenital heart diseases Myocardial infarction Peripheral arterial disease Valvular heart disease Cardiac hemodynamics and physiology Haemostasis and thrombosis