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Review
. 2018 May 30:7:F1000 Faculty Rev-679.
doi: 10.12688/f1000research.14301.1. eCollection 2018.

Recent advances in transcatheter management of pulmonary regurgitation after surgical repair of tetralogy of Fallot

Matthew I Jones  1 , Shakeel A Qureshi  1
Affiliations
Review

Recent advances in transcatheter management of pulmonary regurgitation after surgical repair of tetralogy of Fallot

Matthew I Jones et al. F1000Res. .

Abstract

Surgical repair of tetralogy of Fallot (ToF) in childhood is associated with generally good outcomes, and almost all children can be expected to survive until adulthood. However, significant pulmonary regurgitation leading to progressive right ventricular dilatation is common in teenagers or young adults because of the nature of the surgical intervention. In patients whose repair included placement of a right ventricle to pulmonary artery conduit, it has been possible to place a stented valve within the conduit to treat this. Pulmonary regurgitation after repair of ToF via a transannular patch technique has historically involved repeat surgery as the dimensions of the right ventricular outflow tract have been too large for commercially available valves. This review summarises the novel transcatheter valves available for management of pulmonary regurgitation after surgical repair of ToF in patients in whom the dimensions of the right ventricular outflow tract have previously been considered too large for transcatheter valve implantation.

Keywords: pulmonary regurgitation; tetralogy of Fallot; transcatheter.

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Conflict of interest statement

Competing interests: Shakeel Qureshi is a consultant for Venus Medetch and principle investigator for the CE Study of Venus P-Valve.No competing interests were disclosed.No competing interests were disclosed.No competing interests were disclosed.

Figures

Figure 1.
Figure 1.. Venus P-valve.
The Venus P-valve (Venus MedTech, Shanghai, China) has proximal and distal flares that anchor the valve in the right ventricular outflow tract. The distal flare is not covered, permitting unobstructed flow into the branch pulmonary arteries.
Figure 2.
Figure 2.. Angiographic appearances of the Venus P-valve after deployment as seen in the left anterior oblique/cranial and lateral projections.
Here, the Venus P-valve (Venus MedTech, Shanghai, China) is at level of the proximal markers, immediately above the right ventricular outflow tract.
Figure 3.
Figure 3.. Harmony transcatheter pulmonary valve.
The Medtronic Harmony transcatheter pulmonary valve (hTPV) system (Medtronic) has been specifically developed for implantation in non-uniform right ventricular outflow tracts after transannular patch repair of tetralogy of Fallot, building on Medtronic’s success with the Melody valve.
Figure 4.
Figure 4.. Pulsta valve.
The Pulsta valve (TaeWoong Medical Co. Ltd) has been successfully implanted in a small number of human subjects.
See this image and copyright information in PMC

References

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    2. F1000 Recommendation

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    2. F1000 Recommendation

    1. Promphan W, Prachasilchai P, Siripornpitak S, et al. : Percutaneous pulmonary valve implantation with the Venus P-valve: clinical experience and early results. Cardiol Young. 2016;26(4):698–710. 10.1017/S1047951115001067 - DOI - PubMed
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    2. F1000 Recommendation

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