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Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
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Progress With New Challenges: Self-Expanding Transcatheter Pulmonary Valve Endocarditis
David Gregg1, Payton Kendsersky1, Stephanie S Gaydos2
1Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
JACC. Case Reports
|May 30, 2025
Summary
The Harmony transcatheter pulmonary valve, used for severe pulmonary regurgitation, can be challenging to surgically explant due to its design. Careful consideration of valve selection and explantation complexity is crucial for patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- The Harmony valve is the first FDA-approved transcatheter pulmonary valve for severe pulmonary regurgitation (PR).
- It expands transcatheter options for patients with residual PR post-childhood surgery.
- Risks and endocarditis treatment associated with this valve remain unclear.
Observation:
- This report details the first surgical explantation of the Harmony valve.
- The explanted valve featured an extensive skirt extending into the right ventricular outflow tract and pulmonary artery.
- Surgical dissection proved more complex than with standard surgical valves.
Findings:
- Surgical explantation of the Harmony valve was safely achieved despite increased complexity.
- The valve's extensive skirt contributed to the difficulty of removal.
Implications:
- While transcatheter therapies offer less invasive benefits, they may present challenges during surgical explantation.
- Tradeoffs between less invasive procedures and explantation complexity must be considered in valve selection and timing.
- This case highlights the need for careful planning in managing potential complications associated with novel transcatheter devices.
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