Bilateral branch pulmonary artery Pulsta valve implantation for treatment of large right ventricular outflow tract in a high‐risk patient

• Published in: Catheterization and cardiovascular interventions 2021-11, Vol.98 (5), p.923-927
• Main Authors: Kim, Jung Yoon, Kim, Seong‐Ho, Jang, So Ick
• Format: Article
• Language: English
• Subjects: Cardiac Catheterization; Cardiovascular disease; Clinical trials; Congenital diseases; congenital heart disease adults; Congestive heart failure; Feasibility studies; Heart surgery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Middle Aged; percutaneous intervention; Prosthesis Design; Pulmonary arteries; Pulmonary artery; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - surgery; Pulmonary Valve - diagnostic imaging; Pulmonary Valve - surgery; pulmonary valve disease; Pulmonary Valve Insufficiency - diagnostic imaging; Pulmonary Valve Insufficiency - etiology; Pulmonary Valve Insufficiency - surgery; Regurgitation; Tetralogy of Fallot; transcatheter valve implantation; Treatment Outcome; Ventricle; Ventricular Outflow Obstruction - diagnostic imaging; Ventricular Outflow Obstruction - etiology; Ventricular Outflow Obstruction - surgery
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.29857

Percutaneous pulmonary valve implantation (PPVI) has been implemented as a novel alternative strategy to surgical pulmonary valve replacement. However, PPVI has an inevitable limitation: the large right ventricular outflow tract (RVOT) lesions exhibit variable geometry and significant pulmonary regurgitation (PR). To overcome this limitation, bilateral branch pulmonary artery (PA) valve implantations using Melody or Sapien valves have been attempted and have shown a reduction in right ventricular volume with clinical benefits in the intermediate term. Nevertheless, these trials also have constraints of large branch PA size. Recently, a feasibility study using the Pulsta valve (Tae Woong Medical Co, Gyeonggi‐do, South Korea) for native RVOTs was reported; the diameter of the Pulsta valve ranges from 18 to 32 mm. Herein, we present a successful percutaneous bilateral branch PA valve implantation using two 32 mm Pulsta valves in a 59‐year‐old man who showed right heart failure with severe pulmonary regurgitation despite several open heart surgeries for tetralogy of Fallot. The main PA was measured to be 49 mm, and both the right and left PAs were measured to be 30 mm.