Page 10 - Journal of Structural Heart Disease Volume 4, Issue 1

Original Scienti c Article
Journal of Structural Heart Disease, February 2018, Volume 4, Issue 1:1-8
DOI: https://doi.org/10.12945/j.jshd.2018.035.17
Received: August 09, 2017 Accepted: August 26, 2017 Published online: February 2018
Transcatheter Pulmonary Valve Replacement: The Venus P valve-Current Status
Wail Alkashkari, MD1, Jamilah AlRahimi, MD1*, Saad Albugami, MD1, Qi-Ling Cao, MD2, Ziyad M. Hijazi, MD, MPH2,3
1 Department of Cardiology, King Saud Bin Abdulaziz University For Health Science and King Faisal Cardiac Center, Jeddah, Saudi Arabia 2 Sidra Cardiac Program, Sidra Medical & Research Center, Doha, Qatar
3 Department of Pediatrics, Weill Cornell Medicine, New York, New York, United States
Abstract
There is growing appreciation for the long-term ad- verse impact of right-sided dysfunction of the pulmo- nary valve in patients with congenital heart disease. Although pulmonary valve stenosis or regurgitation is often tolerated over the short and intermediate terms, the long-term consequences are numerous and in- clude, but are not limited to, right-sided heart failure, arrhythmias, and sudden cardiac death. Surgical right ventricular out ow tract (RVOT) interventions have been performed for many decades as an initial therapy, but comorbidities associated with repeated surgeries are a concern. Transcatheter pulmonary valve replace- ment is safe, e ective, and performed at an increasing number of centers around the world. It o ers an alter- native to traditional surgical techniques and may po- tentially alter the decision-making process whereby valvular replacement is performed prior to the devel- opment of long-term sequelae of RVOT dysfunction. However, only ~15% of potential patients with RVOT dysfunction are suitable for currently approved im- plantable valves (i.e., Melody valve from Medtronic and Edwards Sapien valves from Edwards Lifesciences). These two valve systems are designed and approved for patients with a conduit or bioprosthetic valve be- tween the right ventricle and pulmonary artery, and they exclude most patients who undergo transannu- lar patch repair techniques. The Venus P-valve (Venus Medtech, Shanghai, China) is a recently developed self-expanding transcatheter heart valve designed to adapt to a dilated RVOT and in such it provide patients with a percutaneous interventional option after tran-
sannular patch repair.
Copyright © 2018 Science International Corp.
Key Words
Transcatheter pulmonary valve replacement • Venus P valve-Current status • Congenital heart disease
Introduction
Progress in surgical interventions for congenital heart disease over the past few decades has allowed more children to survive well into adulthood. Most of these patients will require multiple surgical proce- dures over their lifetime. This can be associated with increased morbidity and mortality [1, 2] due to chest adhesions, bleeding, cardiac ischemia, arrhythmia burden, heart failure, and multi-organ dysfunction [3- 7]. Since the introduction of the rst balloon-expand- able valve in the pulmonary position by Bonhoe er et al. [8] in 2000, advances in interventional cardiol- ogy and transcatheter pulmonary valve replacement (tPVR) have revolutionized the management of these patients. The availability of these minimally invasive and e ective therapies may allow for earlier treat- ment of right ventricular out ow tract (RVOT) dys- function before the onset of irreversible ventricular remodeling and dysfunction. Moreover, transcathe- ter options can reduce the need for multiple surgical interventions over a patient’s lifetime, thereby mini- mizing the morbidity of this growing patient popu-
* Corresponding Author:
Wail Alkashkari, MD
Department of Cardiology
King Saud Bin Abdulaziz University For Health Science and King Faisal Cardiac Center P.O. Box 9515, Jeddah, 21423, Saudi Arabia
Tel. +966 5 056 16454; Fax: +966 1 222 66200; E-Mail: wakash73@hotmail.com
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
© 2018 Journal of Structural Heart Disease Published by Science International Corp. ISSN 2326-4004
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