Percutaneous Pulmonary Valve Implantation In Native Right Ventricular Outflow Tract Using Myval™ Without Pre-Stenting

Percutaneous pulmonary valve implantation was introduced two decades ago as a low-risk alternative for patients previously operated with conduits presenting RVOT dysfunction. Recently, Sapien valve was approved for use in the pulmonary position but this valve cannot be used for RVOT larger than 29 mm. Self-expanding valves can be used for large native RVOT, however, there are some cases not suitable for this technique. The advent of 30.5 and 32 mm Myval™ balloon expandable heart valves provided the possibility to treat these patients percutaneously. The objective of this study is to describe immediate results of 30.5 and 32 mm MyVal™ valves implantation in native and large RVOT without pre-stenting.

Seventeen patients underwent to percutaneous pulmonary valve implantation to treat large and native dysfunctional RVOT. The mean patient age was 26.2 ± 13.0 years, and the mean patient weight was 64.8 ± 14.8 kg. All patients had been previously submitted to at least one surgical procedure. The implantation was directly performed without pre-stenting in all patients. The mean basal RVOT diameter was 27.6 ± 2.1 mm. Five patients underwent to 30.5 mm and 12 patients underwent to 32 mm pulmonary valve implantation. All patients had satisfactory valve function immediately after valve implantation. The average hospital stay was 3.2 days.

In conclusion, the 30.5 and 32 mm MyVal™ valves have significant potential for treating patients with large native RVOTs, providing a safe and effective alternative to traditional surgical approaches and existing percutaneous options.