Morphological changes and number of candidates for transcatheter pulmonary valve implantation in conduits involving heterograft and artificial material

• Published in: Heart and vessels 2021-09, Vol.36 (9), p.1384-1391
• Main Authors: Fujimoto, Kazuto, Kitano, Masataka, Sakaguchi, Heima, Ohuchi, Hideo, Hoashi, Takaya, Ichikawa, Hajime, Shiraishi, Isao, Kurosaki, Kenichi
• Format: Article
• Language: English
• Subjects: Animals; Biomedical Engineering and Bioengineering; Cardiac Catheterization; Cardiac Surgery; Cardiology; Catheterization; Cattle; Dacron; Heart; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Hemodynamics; Heterografts; Humans; Implantation; Medicine; Medicine & Public Health; Morphology; Original Article; Outflow; Pericardium; Polyethylene; Polyethylene terephthalate; Polyethylene Terephthalates; Polytetrafluoroethylene; Pulmonary arteries; Pulmonary artery; Pulmonary Valve - diagnostic imaging; Pulmonary Valve - surgery; Repair; Retrospective Studies; Treatment Outcome; Vascular Surgery; Ventricle; Ventricular Outflow Obstruction
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-021-01808-z

Heterograft and artificial materials have been used for extracardiac conduit implantation to create right ventricular (RV) to pulmonary artery (PA) continuity for biventricular repair in Japan because of the limited availability of homograft valves. However, few studies have examined morphological changes and number of candidates for transcatheter pulmonary valve implantation (TPVI) in which the conduit includes more than one type of material. Overall, 88 patients who underwent biventricular repair with an external conduit were included in this evaluation. Based on catheterization data and surgical records, we estimated morphological change in the RV outflow tract for each material and the number of candidates for Melody valve implantation based on premarket approval application criteria established by the U.S. Food and Drug Administration. There were 63 candidates for TPVI (72%, 63/88). Median anteroposterior and lateral diameter of the RV outflow tract was 20.4 mm (range 9.0–41.5) and 17.8 mm (range 9.5–34.9), respectively. Bovine pericardium tended to dilate by 11.2%. Polytetrafluoroethylene (ePTFE), homograft, and Dacron polyethylene terephthalate (PET) tended to become stenotic by 11.1%, 28.0%, and 13.4%, respectively. While ePTFE (27/33, 82%) and Dacron PET (2/2, 100%) were highly suitable for TPVI, bovine pericardium (32/48, 67%) was less suitable. In Japan, many patients with hemodynamic indications for TPVI following extracardiac conduit implantation to create RV to PA continuity may also meet the morphological indications.