Early Outcomes of Percutaneous Pulmonary Valve Implantation with Pulsta and Melody Valves: The First Report from Korea

• Type of Material: Article
• Authors: Ah Young Kim, Yonsei University; Jo Won Jung, Yonsei University; Se Yong Jung, Yonsei University; Jae Shin, Emory University; Lucy Youngmin Eun, Yonsei University; Nam Kyun Kim, Emory University; Jae Young Choi, Yonsei University
• Language: English
• Date: 2020-09-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2020 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/jcm9092769
• Title of Journal or Parent Work: JOURNAL OF CLINICAL MEDICINE
• Volume: 9
• Issue: 9
• Start Page: 1
• End Page: 14
• Grant/Funding Information: This research received no external funding.
• Keywords: Science & Technology; pediatrics; MANAGEMENT; CONDUIT; heart diseases; heart valve prosthesis; Life Sciences & Biomedicine; RIGHT-VENTRICLE; IMPROVEMENT; General & Internal Medicine; CONGENITAL HEART-DISEASE; pulmonary valve; CONSEQUENCES; STENT FRACTURE; Medicine, General & Internal; pulmonary heart disease; TERM OUTCOMES; REPLACEMENT; CLINICAL-EXPERIENCE
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Percutaneous pulmonary valve implantation (PPVI) is used to treat pulmonary stenosis (PS) or pulmonary regurgitation (PR). We described our experience with PPVI, specifically valve-in-valve transcatheter pulmonary valve replacement using the Melody valve and novel self-expandable systems using the Pulsta valve. We reviewed data from 42 patients undergoing PPVI. Twenty-nine patients had Melody valves in mostly bioprosthetic valves, valved conduits, and homografts in the pulmonary position. Following Melody valve implantation, the peak right ventricle-to-pulmonary artery gradient decreased from 51.3 ± 11.5 to 16.7 ± 3.3 mmHg and right ventricular systolic pressure fell from 70.0 ± 16.8 to 41.3 ± 17.8 mmHg. Thirteen patients with native right ventricular outflow tract (RVOT) lesions and homograft underwent PPVI with the new self-expandable Pulsta valve—a nitinol wire stent mounted with a trileaflet porcine pericardial valve. Following Pulsta valve implantation, cardiac magnetic resonance imaging showed a decreased PR fraction and that the right ventricular end-diastolic volume index decreased from 166.1 ± 11.9 to 123.6 ± 12.4 mL/m2. There were no mortality, severe procedural morbidity, or valve-related complications. At the mean 14.2 month (4–57 months) follow-up, no patients had more than mild PR. PPVI using Melody and Pulsta valves was first shown to provide excellent early outcomes without serious adverse event in most patients with RVOT dysfunction in Korea.