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Updated: Aug 9, 2026
Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
Transcatheter versus surgical pulmonary valve replacement in native RVOT: A 3-year propensity score-matched study
Borja Rivero-Santana1, Enrique Balbacid-Domingo2, Santiago Jiménez-Valero3
1Department of Cardiology. La Paz University Hospital, Madrid, Spain; Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.; European University of Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
Transcatheter pulmonary valve replacement (TPVR) offers comparable 3-year outcomes to surgical pulmonary valve replacement (SPVR) for right ventricular outflow tract dysfunction. TPVR resulted in fewer complications and shorter hospital stays, supporting its use as a less invasive option.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Surgical pulmonary valve replacement (SPVR) is standard for native or patched right ventricular outflow tract (nRVOT) dysfunction.
- Transcatheter pulmonary valve replacement (TPVR) is a less invasive alternative, but comparative data are limited.
Purpose of the Study:
- To compare clinical outcomes and valve performance between TPVR and SPVR in patients with nRVOT dysfunction.
- To evaluate the efficacy and safety of TPVR versus SPVR.
Main Methods:
- Retrospective identification of patients with nRVOT dysfunction undergoing TPVR or SPVR.
- Propensity score-matching of TPVR cases 1:2 to SPVR.
- Primary outcome: freedom from all-cause mortality, prosthetic valve endocarditis, or valve-related reintervention at 3 years.
Main Results:
- Matched cohort: 123 patients (41 TPVR, 82 SPVR).
- 3-year freedom from primary outcome: 95.2% for TPVR vs. 91.5% for SPVR (p=0.63).
- TPVR showed fewer in-hospital complications (4.9% vs. 18.3%; p=0.04), shorter ICU/hospital stays, and lower mean gradients post-procedure and at 3 years (p<0.05).
- Pulmonary regurgitation was comparable at 3 years (90.0% vs. 94.5%; p=0.22).
Conclusions:
- TPVR demonstrated comparable 3-year clinical outcomes to SPVR in nRVOT dysfunction.
- TPVR offers advantages including fewer in-hospital complications, shorter hospital stays, and superior hemodynamic performance.
- TPVR is an effective, less invasive alternative, though longer-term data are needed.
