Transcatheter pulmonary valve implantation (TPVI)
Transcatheter pulmonary valve implantation (TPVI) is a relatively new method of treatment for patients with right ventricular outflow tract (RVOT) dysfunction after surgical correction of congenital heart disease with the use of pulmonary conduit. There are only few reports of TPVI in patients in whom a surgical correction of RVOT was performed with a pericardial patch.
In the Institute of Cardiology TPVI was performed in 10 patients after surgical tetralogy of Fallot or pulmonary atresia correction of RVOT with a pericardial patch. Melody Medtronic valve (22 mm) was implanted in 3 pts. The biological Sapien-Edwards valve (23 and 26 mm) routinely used for transcatheter aortic valve implantation permited its implantation in patients with a wider RVOT. The procedure was preceded by implantation of one or two metal stents.
TPVI was successfully performed in all pts without complications. Time of the procedure varied from 80 to 225, mean 135 min. In all cases the implanted valve was competent, with mean pulmonary gradient 19,4 ? 8,7 mmHg. There were no complications. Hospitalization time was 2-3 days.
We proved that TPVI may be successfully and safely performed in pts with patched RVOT, who are most often affected by severe pulmonary regurgitation.
Procedures performed in the Institute of Cardiology are among the first in the world.