Percutaneous pulmonary valve implantation using Edwards SAPIEN transcatheter heart valve in different types of conduits: initial results of a single center experience

Congenit Heart Dis. 2013 Sep-Oct;8(5):411-7. doi: 10.1111/chd.12047. Epub 2013 Mar 1.

Abstract

Background: Percutaneous pulmonary valve implantation is frequently used as a less invasive method in patients with conduit dysfunction. The common valve type cannot be used in conduits with a diameter larger than 22 mm. There has been limited experience concerning the used of the SAPIEN Transcatheter Heart Valve, produced for use in conduits with a large diameter. This study presents hemodynamic and early follow-up results from a single center in Turkey concerning the use of the SAPIEN Transcatheter Heart Valve in different types of conduits and different lesions.

Patients and method: Between October 2010 and July 2012, seven SAPIEN Transcatheter Heart Valve implantations were performed. There was mixed type 2 pure insufficiency with stenosis and insufficiency in five patients. Three different conduits were used, and one native pulmonary artery process was performed. Patients were followed for hemodynamic findings, functional capacities, valve competence, reshrinking, and breakage in the stent, and the results were evaluated.

Results: Implantations were successfully performed in all patients. Right ventricular pressures and gradients were significantly reduced, and there was no pulmonary regurgitation in any patient. Functional capacities evidently improved in all patients except for one with pulmonary hypertension. No major complication was observed. During the mean time of follow-up (7.2 ± 4.7 months), no valve insufficiency or stent breakage was observed.

Conclusion: Procedural results and short-term outcomes of the SAPIEN Transcatheter Heart Valve were very promising in the patients included in the study. The SAPIEN Transcatheter Heart Valve can be a good alternative to surgical conduit replacement, particularly in patients with larger and different types of conduits.

Keywords: Different Types Conduits; Edwards SAPIEN; Initial Results; Percutaneous; Pulmonary Valve Implantation.

MeSH terms

  • Adolescent
  • Adult
  • Cardiac Catheterization / methods*
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis Implantation / methods*
  • Hemodynamics
  • Humans
  • Male
  • Morbidity
  • Prosthesis Design
  • Pulmonary Valve Insufficiency / mortality
  • Pulmonary Valve Insufficiency / physiopathology
  • Pulmonary Valve Insufficiency / surgery*
  • Treatment Outcome
  • Ventricular Function, Right
  • Ventricular Outflow Obstruction / mortality
  • Ventricular Outflow Obstruction / physiopathology
  • Ventricular Outflow Obstruction / surgery*
  • Ventricular Pressure
  • Young Adult