Percutaneous VenusP-valve implantation in the paediatric population.

Objectives: To assess short- and medium-term outcomes of VenusP-valve implantation in the pulmonary position in the paediatric population.

Background: Percutaneous pulmonary valve implantation is now an established alternative to surgical pulmonary valve replacement, especially in those with conduits in the right ventricular outflow tract. The VenusP-valve™ (Venus Medtech, Shanghai, China) has demonstrated early efficacy in the adult population with larger conduit-free right ventricular outflow tracts. However, its use in children has not been well described.

Methods: Retrospective review of patients under 18 years of age undergoing VenusP-valve implantation at a single institution between June 2015 and February 2023.

Results: Fifteen patients under the age of 18 years underwent VenusP-valve™ implantation. All had severe pulmonary regurgitation and fulfilled accepted criteria for pulmonary valve implantation. Mean age at valve implantation was 14.1 (range 9.8-17.9) years, and mean weight was 54.9 (34.0-98.5) kg. The valve was deployed successfully in all the patients. The valve diameter and length ranged between 28-36 mm and 25-35 mm, respectively. Mean follow-up was 3.4 (0.5-8.1) years. At follow-up, twelve patients have undergone magnetic resonance imaging MRI as part of the regular surveillance. Indexed right ventricular end-diastolic volume improved from 157.8 (140.0-197.0) ml/m² to 117.6 (91.0-152.0) ml/m² (p = 0.004). Pulmonary regurgitation fraction had reduced from a mean of 44.3 (31.0-60.0) % to 3.6 (0.0-15.0) % (p = 0.003).

Conclusion: This study demonstrates the safety and feasibility of the VenusP-valve implantation in children. Medium-term follow-up suggests that valve implantation is associated with a reduction in the degree of pulmonary regurgitation and right ventricular end-diastolic volume.