Transthoracic Salus Valve Feasibility Study: Short-Term Outcomes of a Transcatheter Self-Expandable Pulmonary Valve

Jun Dong, Junwu Su, Aijun Liu, Jing Du, Jing Yang, Qiangqiang Li, Bin Li, Ming Yang, Zhijun Wang, Q. Bao
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Abstract

Objective: The size and morphology of the right ventricular outflow tract (RVOT) in patients suffering from long-term pulmonary regurgitation (PR) after native RVOT (NRVOT) reconstruction are important factors affecting the feasibility, safety, and effectiveness of transcatheter pulmonary valve replacement. The purpose of this study was to evaluate the feasibility, safety, and effectiveness of a transthoracic Salus valve (Balance Medical Technology Co., Ltd, Beijing, China) in patients with moderate-to-severe PR after NRVOT reconstruction. Methods: Patients with moderate-to-severe PR after NRVOT reconstruction were selected between June 2021 and November 2021 at Beijing Anzhen Hospital. Demographic data as well as preoperative, intraoperative, and follow-up data were reviewed. Results: Ten patients with moderate-to-severe PR after NRVOT reconstruction underwent physical examination, transthoracic echocardiography, and cardiovascular magnetic resonance imaging. Seven patients were selected for transthoracic Salus valve replacement. Six patients underwent implantation of the Salus valve successfully. One valve migrated and was embolized during recovery of the delivery device; the Salus valve was surgically explanted and sutured to the inner wall of the main pulmonary artery. At a mean follow-up of (5.5 ± 1.1) months, dysfunction or migration of the Salus valve embolism was not observed. Conclusions: This early feasibility study demonstrates the feasibility, safety, and effectiveness of transthoracic implantation of a Salus valve in patients with moderate-to-severe PR after NRVOT reconstruction. The short-term effectiveness is clear, medium and long-term effectiveness requires longer follow-up.
经胸Salus瓣膜可行性研究:经导管自膨胀肺瓣膜的短期疗效
目的:对长期肺返流(PR)患者进行天然右心室流出道(RVOT)重建后右心室流出道(RVOT)的大小和形态是影响经导管肺瓣膜置换术可行性、安全性和有效性的重要因素。本研究的目的是评估经胸主动脉瓣(Balance Medical Technology Co., Ltd, Beijing, China)在NRVOT重建后中重度PR患者中的可行性、安全性和有效性。方法:选择2021年6月至2021年11月北京安贞医院NRVOT重建术后中重度PR患者。我们回顾了人口统计资料以及术前、术中和随访资料。结果:10例NRVOT重建后中重度PR患者行体格检查、经胸超声心动图及心血管磁共振成像。选择7例患者行经胸上睑瓣置换术。6例患者成功植入上睑瓣。一个瓣膜移位,并在运送装置恢复过程中栓塞;手术切除肺动脉瓣并将其缝合于肺动脉主动脉内壁。在平均(5.5±1.1)个月的随访中,未观察到Salus瓣栓塞的功能障碍或迁移。结论:这项早期可行性研究证明了经胸主动脉瓣植入术治疗NRVOT重建后中重度PR患者的可行性、安全性和有效性。短期疗效明确,中长期疗效需要较长的随访时间。
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