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Transcatheter Pulmonary Valve Replacement With the Sapien Prosthesis
Shabana Shahanavaz1, Evan M Zahn2, Daniel S Levi3
1Division of Cardiology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.
Journal of the American College of Cardiology
|December 11, 2020
Summary
Transcatheter pulmonary valve replacement (TPVR) using Sapien XT or Sapien 3 valves showed excellent short-term outcomes across various right ventricular outflow tract anatomies. Further research is needed for long-term insights.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Limited data exists on transcatheter pulmonary valve replacement (TPVR) outcomes using Sapien XT or Sapien 3 (S3) valves.
- This study addresses the need for more information on TPVR with these specific balloon-expandable valves.
Purpose of the Study:
- To report short-term outcomes of a large patient cohort undergoing TPVR with Sapien XT or S3 valves.
- To analyze outcomes based on different right ventricular outflow tract (RVOT) anatomies.
Main Methods:
- Retrospective data collection from a multicenter registry of patients who underwent attempted TPVR with Sapien XT or S3 valves.
- Characterization of patient demographics, procedural details, and short-term outcomes, stratified by RVOT anatomy.
Main Results:
- The study included 774 patients across 23 centers, with 78% receiving the S3 valve.
- Technical success was high (97.4%), with serious adverse events in 10% of patients.
- Excellent short-term valve function was observed, though 8.5% experienced moderate or greater pulmonary regurgitation or elevated gradients.
Conclusions:
- Transcatheter pulmonary valve replacement with balloon-expandable valves demonstrates generally excellent acute outcomes in all RVOT types.
- Longer follow-up and additional data are crucial for a comprehensive understanding of TPVR efficacy and safety.
