Percutaneous pulmonary valve implantation using the Edwards SAPIEN valve can be a feasible alternative for high-surgical-risk patients with a native right ventricular outflow tract patch.
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May offer a percutaneous option in high-risk native RVOT cases; leaves open prospective validation before wider use.
Percutaneous pulmonary valve implantation (PPVI) is now an accepted alternative option to conventional surgery for patients with dysfunctional conduits between the right ventricle and pulmonary artery. PPVI will reduce the total number of repeat operations in such patients. However, surgery remains the primary option in postoperative tetralogy of Fallot patients with severe pulmonary regurgitation who underwent transannular patch reconstruction of their right ventricular outflow tract (RVOT). Traditionally, an RVOT patch is considered a relative contraindication to PPVI, however, in selected patients PPVI was successfully performed. We report the case of a 12-year-old patient after neonatal repair of tetralogy of Fallot and pulmonary atresia, who developed advanced liver disease and severe pulmonary regurgitation. In this patient, the risk for surgical valve replacement was considered too high and he was treated with percutaneous implantation of the Edwards SAPIEN™ transcatheter heart valve.
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Guccione et al. (2012) studied this question.
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