Key result
Transcatheter pulmonary valve replacement with the Venus-P valve was successfully implanted in 98% of patients, significantly reducing pulmonary regurgitant fraction from 42.6% to 4.3% (p<0.001) at follow-up.
Why the study?
The authors sought to evaluate single-center outcomes, procedural techniques, and valve sizing considerations regarding expansion and geometry during transcatheter pulmonary valve replacement with the Venus-P valve.
Does transcatheter pulmonary valve replacement with the Venus-P valve improve hemodynamics and clinical outcomes in patients with dysfunctional right ventricular outflow tracts?
Cohort (n=42)
No
Does transcatheter pulmonary valve replacement with the Venus-P valve improve hemodynamics and clinical outcomes in patients with dysfunctional right ventricular outflow tracts?
Transcatheter pulmonary valve replacement with the Venus-P self-expanding valve is safe and effective for dysfunctional native or patched RVOTs, leading to significant improvements in right ventricular volumes and pulmonary regurgitation at medium-term follow-up.
Supports Venus-P feasibility in adult congenital PVR; leaves open durability and multicenter validation.
We share a single-center experience of transcatheter pulmonary valve replacement (PVR) with the Venus-P valve, discussing procedural insights, considerations for valve sizing in relation to valve expansion and geometry, and associated outcomes. Retrospective review of 42 consecutive cases from January 2017 to March 2024. The median age and weight of the cohort were 39.6 (27.3, 58.6) years and 69.8 (59.8, 85.3) kg and the Venus-P valve was successfully implanted in 98%. Severe adverse events included valve migration requiring surgical explant and PVR (n = 1), sustained ventricular arrhythmia (n = 1), and endocarditis (n = 1). At mean follow-up of 20.3 ± 19.6 months, there was no deterioration in valve performance and statistically significant improvement in NYHA class, right ventricular volumes, biventricular stroke volume, and LV ejection fraction. Cinefluoroscopic measurements of the deployed valves showed highest expansion and lowest eccentricity at valve coaptation level and greater frame deformation at the inflow compared to outflow flare. Supra-annular (n = 9) implant showed a higher expansion of the straight valve section compared to transannular (n = 32) deployment, related to lesser degree of valve oversizing and tissue characteristics at implant site. Transcatheter PVR with the Venus-P valve can be safely performed in a broad range of anatomies with clinical benefit at medium-term follow-up. Valve sizing focused on adequate deformation of inflow and outflow flares at implant location with minimal constrain at the valve portion and supra-annular positioning, may result in a higher degree of valve expansion and circularity. Ongoing follow-up of this cohort will provide important insights into valve longevity and long-term outcomes.
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Kang et al. (2025) conducted a cohort in Dysfunctional right ventricular outflow tract (RVOT) (n=42). Venus-P self-expanding pulmonary valve was evaluated on Procedural success. Transcatheter pulmonary valve replacement with the Venus-P valve was successfully implanted in 98% of patients, significantly reducing pulmonary regurgitant fraction from 42.6% to 4.3% (p<0.001) at follow-up.
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