The Initial Middle Eastern Experience With the Alterra Adaptive Pre-Stent: Single-Center Outcomes From Saudi Arabia

Area of Science:

• Cardiology
• Interventional Cardiology
• Congenital Heart Disease

Background:

• The Alterra Adaptive Pre-Stent, used with the Edwards SAPIEN 3 valve, provides a novel transcatheter option for patients with severely dilated right ventricular outflow tracts (RVOTs).
• These patients were previously unsuitable for conventional transcatheter pulmonary valve replacement (TPVR).
• No prior experience with this system had been reported from the Middle East.

Purpose of the Study:

• To report the first Middle Eastern experience with the Alterra Adaptive Pre-Stent.
• To evaluate the safety, feasibility, and early outcomes of TPVR using this system in patients with complex RVOT anatomies.

Main Methods:

• A retrospective, single-center analysis was conducted at Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
• Ten patients with native or surgically patched RVOTs underwent TPVR using the Alterra Pre-Stent and Edwards SAPIEN 3 valve between April and July 2025.
• Patient selection, procedural data, and early clinical outcomes were reviewed.

Main Results:

• All 10 patients (mean age 30 ± 7.1 years) underwent successful implantation with 100% procedural success.
• Device positioning was accurate, with no significant residual gradient or pulmonary regurgitation.
• No major complications occurred, and all patients remained clinically stable with improved functional status at a median follow-up of 31 days.

Conclusions:

• This study represents the first reported experience of the Alterra Adaptive Pre-Stent in the Middle East.
• Early results indicate the device is safe, technically feasible, and effective in selected patients with complex RVOT anatomies.
• The Alterra Pre-Stent may broaden the applicability of TPVR in the region.