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Abstract

Transcatheter valve therapeutics has revolutionized interventional cardiology in the twenty-first century. When Bonhoeffer and colleagues performed the first-in-man percutaneous pulmonary valve implantation (PPVI) in 2000, it changed the treatment paradigm of what we can offer patients with congenital heart disease (CHD). In the span of this chapter, we will discuss the underlying burden of pulmonary valve disease in the CHD population and the current indications for surgical pulmonary valve replacement. We will outline the PPVI procedure from procedural and technologic perspective and then review the state of the evidence regarding clinical outcomes, risks & benefits, and potential future perspectives.

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References

  1. Frigiola A, Giamberti A, Chessa M, Di Donato M, Abella R, Foresti S, Carlucci C, Negura D, Carminati M, Buckberg G, Menicanti L. RESTORE group. Right ventricular restoration during pulmonary valve implantation in adults with congenital heart disease. Eur J Cardiothorac Surg. 2006;29:S279–85.

    Article  PubMed  Google Scholar 

  2. Geva T. Repaired tetralogy for Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Magn Reson. 2011;13:9–32.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Buechel ER, Dave HH, Kellenberger CJ, Dodge-Khatami A, Pretre R, Berger F, Bauersfeld U. Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: assessment by cardiovascular magnetic resonance. Eur Heart J. 2005;26:2721–7.

    Article  PubMed  Google Scholar 

  4. Therrien J, Provost Y, Merchant N, Williams W, Colman J, Webb G. Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. Am J Cardiol. 2005;95:779–82.

    Article  PubMed  Google Scholar 

  5. Lee C, Park CS, Lee CH, Kwak JG, Kim SJ, Shim WS, Song JY, Choi EY, Lee SY. Durability of bioprosthetic valves in the pulmonary position: long-term follow-up of 181 implants in patients with congenital heart disease. J Thorac Cardiovasc Surg. 2011;142:351–8.

    Article  PubMed  Google Scholar 

  6. Ilbawi MN, Lockhart CG, Idriss FS, DeLeon SY, Muster AJ, Duffy CE, Paul MH. Experience with St. Jude Medical valve prosthesis in children. A word of caution regarding right-sided placement. J Thorac Cardiovasc Surg. 1987;93:73–9.

    CAS  PubMed  Google Scholar 

  7. Miyamura H, Kanazawa H, Hayashi J, Eguchi S. Thrombosed St. Jude Medical valve prosthesis in the right side of the heart in patients with tetralogy of Fallot. J Thorac Cardiovasc Surg. 1987;94:148–50.

    CAS  PubMed  Google Scholar 

  8. Waterbolk TW, Hoendermis ES, den Hamer IJ, Ebels T. Pulmonary valve replacement with a mechanical prosthesis. Promising results of 28 procedures in patients with congenital heart disease. Eur J Cardiothorac Surg. 2006;30:28–32.

    Article  PubMed  Google Scholar 

  9. Gulbins H, Kreuzer E, Reichart B. Homografts: a review. Expert Rev. Cardiovasc Ther. 2003;1:533–9.

    Article  PubMed  Google Scholar 

  10. Turrentine MW, McCarthy RP, Vijay P, Fiore AC, Brown JW. Polytetrafluoroethylene monocusp valve technique for right ventricular outflow tract reconstruction. Ann Thorac Surg. 2002;74:2202–5.

    Article  PubMed  Google Scholar 

  11. Oosterhof T, Meijboom FJ, Vliegen HW, Hazekamp MG, Zwinderman AH, Bouma BJ, van Dijk AP, Mulder BJ. Long-term follow-up of homograft function after pulmonary valve replacement in patients with tetralogy of Fallot. Eur Heart J. 2006;27(12):1478–84.

    Article  PubMed  Google Scholar 

  12. Brown JW, Ruzmetov M, Vijay P, Rodefeld MD, Turrentine MW. Right ventricular outflow tract reconstruction with a polytetrafluoroethylene monocusp valve: a twelve-year experience. J Thorac Cardiovasc Surg. 2007;133(5):1336–43.

    Article  PubMed  Google Scholar 

  13. Discigil B, Dearani JA, Puga FJ, Schaff HV, Hagler DJ, Warnes CA, Danielson GK. Late pulmonary valve replacement after repair of tetralogy of Fallot. J Thorac Cardiovasc Surg. 2001;121(2):344–51.

    Article  CAS  PubMed  Google Scholar 

  14. Yemets IM, Williams WG, Webb GD, Harrison DA, McLaughlin PR, Trusler GA, Coles JG, Rebeyka IM, Freedom RM. Pulmonary valve replacement late after repair of tetralogy of Fallot. Ann Thorac Surg. 1997;64(2):526–30.

    Article  CAS  PubMed  Google Scholar 

  15. Holst KA, Dearani JA, Burkhart HM, Connolly HM, Warnes CA, Li Z, Schaff HV. Risk factors and early outcomes of multiple reoperations in adults with congenital heart disease. Ann Thorac Surg. 2011;92(1):122–30.

    Article  PubMed  Google Scholar 

  16. Bonhoeffer P, Boudjemline Y, Saliba Z, Merckx J, Aggoun Y, Bonnet D, Acar P, Le Bidois J, Sidi D, Kachaner J. Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet. 2000;356(9239):1403–5.

    Article  CAS  PubMed  Google Scholar 

  17. Cheatham JP, Hellenbrand WE, Zahn EM, Jones TK, Berman DP, Vincent JA, McElhinney DB. Clinical and hemodynamic outcomes up to 7 years after transcatheter pulmonary valve replacement in the US melody valve investigational device exemption trial. Circulation. 2015;131(22):1960–70.

    Article  PubMed  Google Scholar 

  18. Kenny D, Hijazi ZM, Kar S, Rhodes J, Mullen M, Makkar R, Shirali G, Fogel M, Fahey J, Heitschmidt MG, Cain C. Percutaneous implantation of the Edwards SAPIEN transcatheter heart valve for conduit failure in the pulmonary position: early phase 1 results from an international multicenter clinical trial. J Am Coll Cardiol. 2011;58(21):2248–56.

    Article  PubMed  Google Scholar 

  19. Warnes CA, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118:e714–833.

    Article  PubMed  Google Scholar 

  20. Simpson KE, Huddleston CB, Foerster S, Nicholas R, Balzer D. Successful subxyphoid hybrid approach for placement of a Melody percutaneous pulmonary valve. Catheter Cardiovasc Interv. 2011;78(1):108–11.

    Article  PubMed  Google Scholar 

  21. Morray BH, McElhinney DB, Cheatham JP, Zahn EM, Berman DP, Sullivan PM, Lock JE, Jones TK. Risk of coronary artery compression among patients referred for transcatheter pulmonary valve implantation: a multicenter experience. Circ Cardiovasc Interv. 2013;6(5):535–42.

    Article  PubMed  Google Scholar 

  22. Nordmeyer J, Lurz P, Khambadkone S, Schievano S, Jones A, McElhinney DB, Taylor AM, Bonhoeffer P. Pre-stenting with a bare metal stent before percutaneous pulmonary valve implantation: acute and 1-year outcomes. Heart. 2010;97(2):118–23.

    Article  PubMed  Google Scholar 

  23. Hainstock MR, Marshall AC, Lock JE, McElhinney DB. Angioplasty of obstructed homograft conduits in the right ventricular outflow tract with ultra-noncompliant balloons: assessment of therapeutic efficacy and conduit tears. Circ Cardiovasc Interv. 2013;6(6):671–9.

    Article  PubMed  Google Scholar 

  24. Lurz P, Puranik R, Nordmeyer J, Muthurangu V, Hansen MS, Schievano S, Marek J, Bonhoeffer P, Taylor AM. Improvement in left ventricular filling properties after relief of right ventricle to pulmonary artery conduit obstruction: contribution of septal motion and interventricular mechanical delay. Eur Heart J. 2009;30(18):2266–74.

    Article  PubMed  Google Scholar 

  25. Lurz P, Nordmeyer J, Giardini A, Khambadkone S, Muthurangu V, Schievano S, Thambo JB, Walker F, Cullen S, Derrick G, Taylor AM, Bonhoeffer P. Early versus late functional outcome after successful percutaneous pulmonary valve implantation: are the acute effects of altered right ventricular loading all we can expect? J Am Coll Cardiol. 2011;57(6):724–31.

    Article  PubMed  Google Scholar 

  26. Coats L, Khambadkone S, Derrick G, Hughes M, Jones R, Mist B, Pellerin D, Marek J, Deanfield JE, Bonhoeffer P, Taylor AM. Physiological consequences of percutaneous pulmonary valve implantation: the different behaviour of volume- and pressure-overloaded ventricles. Eur Heart J. 2007;28(15):1886–93.

    Article  PubMed  Google Scholar 

  27. Borik S, Crean A, Horlick E, Osten M, Lee KJ, Chaturvedi R, Friedberg MK, McCrindle BW, Manlhiot C, Benson L. Percutaneous pulmonary valve implantation: 5 years of follow-up: does age influence outcomes? Circ Cardiovasc Interv. 2015;8(2):e001745.

    Article  PubMed  Google Scholar 

  28. Wilson WM, Benson LN, Osten MD, Shah A, Horlick EM. Transcatheter pulmonary valve replacement with the Edwards Sapien System: The Toronto experience. JACC Cardiovasc Interv. 2015;8(14):1819–27.

    Article  PubMed  Google Scholar 

  29. Momenah TS, El Oakley R, Al Najashi K, Khoshhal S, Al Qethamy H, Bonhoeffer P. Extended application of percutaneous pulmonary valve implantation. J Am Coll Cardiol. 2009;53(20):1859–63.

    Article  PubMed  Google Scholar 

  30. Boudjemline Y, Brugada G, Van-Aerschot I, Patel M, Basquin A, Bonnet C, Legendre A, Bonnet D, Iserin L. Outcomes and safety of transcatheter pulmonary valve replacement in patients with large patched right ventricular outflow tracts. Arch Cardiovasc Dis. 2012;105(8–9):404–13.

    Article  PubMed  Google Scholar 

  31. Guccione P, Milanesi O, Hijazi ZM, Pongiglione G. Transcatheter pulmonary valve implantation in native pulmonary outflow tract using the Edwards SAPIEN™ transcatheter heart valve. Eur J Cardiothorac Surg. 2012;41(5):1192–4.

    Article  PubMed  Google Scholar 

  32. Boshoff DE, Cools BL, Heying R, Troost E, Kefer J, Budts W, Gewillig M. Off-label use of percutaneous pulmonary valved stents in the right ventricular outflow tract: time to rewrite the label? Catheter Cardiovasc Interv. 2013;81(6):987–95.

    Article  PubMed  Google Scholar 

  33. Demkow M, Rużyłło W, Biernacka EK, Kalińczuk Ł, Spiewak M, Kowalski M, Sitkowska E, Kuśmierczyk M, Różanski J, Banaś S, Chmielak Z, Hoffman P. Percutaneous Edwards SAPIEN(™) valve implantation for significant pulmonary regurgitation after previous surgical repair with a right ventricular outflow patch. Catheter Cardiovasc Interv. 2014;83(3):474–81.

    Article  PubMed  Google Scholar 

  34. Malekzadeh-Milani S, Ladouceur M, Cohen S, Iserin L, Boudjemline Y. Results of transcatheter pulmonary valvulation in native or patched right ventricular outflow tracts. Arch Cardiovasc Dis. 2014;107(11):592–8.

    Article  PubMed  Google Scholar 

  35. Meadows JJ, Moore PM, Berman DP, Cheatham JP, Cheatham SL, Porras D, Gillespie MJ, Rome JJ, Zahn EM, McElhinney DB. Use and performance of the Melody Transcatheter Pulmonary Valve in native and postsurgical, nonconduit right ventricular outflow tracts. Circ Cardiovasc Interv. 2014;7(3):374–80.

    Article  PubMed  Google Scholar 

  36. Cools B, Brown SC, Heying R, Jansen K, Boshoff DE, Budts W, Gewillig M. Percutaneous pulmonary valve implantation for free pulmonary regurgitation following conduit-free surgery of the right ventricular outflow tract. Int J Cardiol. 2015;186:129–35.

    Article  PubMed  Google Scholar 

  37. McElhinney DB, Hellenbrand WE, Zahn EM, Jones TK, Cheatham JP, Lock JE, Vincent JA. Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter US melody valve trial. Circulation. 2010;122(5):507–16. 44

    Article  PubMed  PubMed Central  Google Scholar 

  38. Vezmar M, Chaturvedi R, Lee KJ, Almeida C, Manlhiot C, McCrindle BW, Horlick EM, Benson LN. Percutaneous pulmonary valve implantation in the young 2-year follow-up. JACC Cardiovasc Interv. 2010;3(4):439–48.

    Article  PubMed  Google Scholar 

  39. Eicken A, Ewert P, Hager A, Peters B, Fratz S, Kuehne T, Busch R, Hess J, Berger F. Percutaneous pulmonary valve implantation: two-centre experience with more than 100 patients. Eur Heart J. 2011;32(10):1260–5.

    Article  PubMed  Google Scholar 

  40. Nordmeyer J, Khambadkone S, Coats L, Schievano S, Lurz P, Parenzan G, Taylor AM, Lock JE, Bonhoeffer P. Risk stratification, systematic classification, and anticipatory management strategies for stent fracture after percutaneous pulmonary valve implantation. Circulation. 2007;115(11):1392–7.

    Article  PubMed  Google Scholar 

  41. Nordmeyer J, Coats L, Lurz P, Lee TY, Derrick G, Rees P, Cullen S, Taylor AM, Khambadkone S, Bonhoeffer P. Percutaneous pulmonary valve-in-valve implantation: a successful treatment concept for early device failure. Eur Heart J. 2008;29(6):810–5.

    Article  PubMed  Google Scholar 

  42. Lurz P, Coats L, Khambadkone S, Nordmeyer J, Boudjemline Y, Schievano S, Muthurangu V, Lee TY, Parenzan G, Derrick G, Cullen S, Walker F, Tsang V, Deanfield J, Taylor AM, Bonhoeffer P. Percutaneous pulmonary valve implantation: impact of evolving technology and learning curve on clinical outcome. Circulation. 2008;117(15):1964–72.

    Article  PubMed  Google Scholar 

  43. Lurz P, Giardini A, Taylor AM, Nordmeyer J, Muthurangu V, Odendaal D, Mist B, Khambadkone S, Schievano S, Bonhoeffer P, Derrick G. Effect of altering pathologic right ventricular loading conditions by percutaneous pulmonary valve implantation on exercise capacity. Am J Cardiol. 2010;105(5):721–6.

    Article  PubMed  Google Scholar 

  44. Plymen CM, Bolger AP, Lurz P, Nordmeyer J, Lee TY, Kabir A, Coats L, Cullen S, Walker F, Deanfield JE, Taylor AM, Bonhoeffer P, Lambiase PD. Electrical remodeling following percutaneous pulmonary valve implantation. Am J Cardiol. 2011;107(2):309–14.

    Article  PubMed  Google Scholar 

  45. Van Dijck I, Budts W, Cools B, Eyskens B, Boshoff DE, Heying R, Frerich S, Vanagt WY, Troost E, Gewillig M. Infective endocarditis of a transcatheter pulmonary valve in comparison with surgical implants. Heart. 2015;101(10):788–93.

    Article  PubMed  Google Scholar 

  46. McElhinney DB, Benson LN, Eicken A, Kreutzer J, Padera RF, Zahn EM. Infective endocarditis after transcatheter pulmonary valve replacement using the Melody valve: combined results of 3 prospective North American and European studies. Circ Cardiovasc Interv. 2013;6(3):292–300.

    Article  PubMed  Google Scholar 

  47. Buber J, Bergersen L, Lock JE, Gauvreau K, Esch JJ, Landzberg MJ, Valente AM, Sandora TJ, Marshall AC. Bloodstream infections occurring in patients with percutaneously implanted bioprosthetic pulmonary valve: a single-center experience. Circ Cardiovasc Interv. 2013;6(3):301–10.

    Article  PubMed  Google Scholar 

  48. Mery CM, Guzmán-Pruneda FA, De León LE, Zhang W, Terwelp MD, Bocchini CE, Adachi I, Heinle JS, McKenzie ED, Fraser CD Jr. Risk factors for development of endocarditis and reintervention in patients undergoing right ventricle to pulmonary artery valved conduit placement. J Thorac Cardiovasc Surg. 2016;151(2):432–9. 441.e1–2

    Article  PubMed  Google Scholar 

  49. Hascoet S, Mauri L, Claude C, Fournier E, Lourtet J, Riou JY, Brenot P, Petit J. infective endocarditis risk after percutaneous pulmonary valve implantation with the Melody and Sapien Valves. JACC Cardiovasc Interv. 2017;10(5):510–7.

    Article  PubMed  Google Scholar 

  50. Vollroth M, Daehnert I, Kostelka M, Wagner R. First case of blood-culture proven Staphylococcus aureus endocarditis of a Sapien® XT valve after percutaneous pulmonary valve implantation. Eur J Cardiothorac Surg. 2015;48(6):e124–5.

    Google Scholar 

  51. Schievano S, Coats L, Migliavacca F, Norman W, Frigiola A, Deanfield J, Bonhoeffer P, Taylor AM. Variations in right ventricular outflow tract morphology following repair of congenital heart disease: implications for percutaneous pulmonary valve implantation. J Cardiovasc Magn Reson. 2007;9(4):687–95.

    Article  PubMed  Google Scholar 

  52. Schievano S, Taylor AM, Capelli C, Coats L, Walker F, Lurz P, Nordmeyer J, Wright S, Khambadkone S, Tsang V, Carminati M, Bonhoeffer P. First-in-man implantation of a novel percutaneous valve: a new approach to medical device development. EuroIntervention. 2010;5(6):745–50.

    Article  PubMed  Google Scholar 

  53. Phillips AB, Nevin P, Shah A, Olshove V, Garg R, Zahn EM. Development of a novel hybrid strategy for transcatheter pulmonary valve placement in patients following transannular patch repair of tetralogy of fallot. Catheter Cardiovasc Interv. 2016;87(3):403–10.

    Article  PubMed  Google Scholar 

  54. Husain J, Praichasilchai P, Gilbert Y, Qureshi SA, Morgan GJ. Early European experience with the Venus P-valve®: filling the gap in percutaneous pulmonary valve implantation. EuroIntervention. 2016;12(5):e643–51.

    Google Scholar 

  55. Promphan W, Prachasilchai P, Siripornpitak S, Qureshi SA, Layangool T. Percutaneous pulmonary valve implantation with the Venus P-valve: clinical experience and early results. Cardiol Young. 2016;26(4):698–710.

    Article  PubMed  Google Scholar 

  56. Garay F, Pan X, Zhang YJ, Wang C, Springmuller D. Early experience with the Venus p-valve for percutaneous pulmonary valve implantation in native outflow tract. Neth Heart J. 2017;25(2):76–81.

    Article  CAS  PubMed  Google Scholar 

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Singh, H.S., Benson, L. (2018). Transcatheter Pulmonary Valve Replacement: Impact on Management. In: Friedberg, M., Redington, A. (eds) Right Ventricular Physiology, Adaptation and Failure in Congenital and Acquired Heart Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-67096-6_17

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