Transcatheter Pulmonary Valve Replacement

Abstract

Since percutaneous balloon pulmonary valvuloplasty for pulmonary valve stenosis (PS) was first successfully performed using a ureteral catheter in 1950s, BPV has become standard of care for treatment of isolated PS over surgical valvotomy. Based on the experience, percutaneous pulmonary valve implantation (PPVI) was performed by Bonhoeffer et al. in patient with a dysfunctional of right ventricle-to-pulmonary artery conduit. In 2010, the Melody valve (Medtronic, Minneapolis, MN) became commercially available in the United States (US) under a humanitarian device exemption protocol, and more recently, was awarded post market approval by the US Food and Drug Administration. Since then, PPVI has been performed for over 4,500 patients in more than 30 countries worldwide. Transcatheter aortic valve replacement (TAVR) has recently became the standard therapy in patients with aortic stensis, and based on this technology, transcatheter pulmonary valve replacement (TPVR) and valve-in-valve procedure has also been able to be performed in patients with adult congenital heart disease. In conformity with heart team approach, hybrid procedures with mutual collaboration from cardiac surgery and interventional cardiology will likely shape the future TPVR. In this chapter, we will review BPV and PPVI/TPVR with particular focus on the indication, technical aspect, clinical outcomes, and potential complications.