Short-term outcomes of transcatheter pulmonary valve replacement with Venus-P valve in patients with moderate-to-severe pulmonary regurgitation and right ventricular systolic dysfunction.
10.3724/zdxbyxb-2024-0493
- Author:
Haiyue XIE
1
,
2
;
Wenhao ZHU
3
;
Zhiyuan XIA
3
;
Gejun ZHANG
2
,
4
Author Information
1. Structural Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China. yuehaix@
2. com.
3. Structural Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China.
4. Structural Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China. gjzhang212@
- Publication Type:Journal Article
- Keywords:
Efficacy;
Pulmonary regurgitation;
Retrospective study;
Right ventricular systolic dysfunction;
Transcatheter pulmonary valve replacement;
Venus-P valve
- MeSH:
Humans;
Pulmonary Valve Insufficiency/surgery*;
Retrospective Studies;
Pulmonary Valve/surgery*;
Heart Valve Prosthesis Implantation/methods*;
Ventricular Dysfunction, Right/physiopathology*;
Treatment Outcome;
Female;
Male;
Child;
Adult;
Heart Valve Prosthesis;
Adolescent;
Cardiac Catheterization/methods*;
Child, Preschool
- From:
Journal of Zhejiang University. Medical sciences
2025;54(3):390-398
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To evaluate the short-term outcomes of transcatheter pulmonary valve replacement (TPVR) using the Venus-P valve in patients with moderate-to-severe pulmonary regurgitation and right ventricular systolic dysfunction (RVSD) following surgical repair of complex congenital heart disease.
METHODS:A retrospective analysis was conducted on patients undergoing Venus-P valve implantation (TPVR group, n=28) or surgical pulmonary valve replacement (SPVR group, n=19) at Fuwai Hospital between February 2014 and February 2024. All patients had moderate-to-severe pulmonary regurgitation with right ventricular ejection fraction less than 45% preoperatively. Postoperative pulmonary valve function and ventricular parameters were assessed at discharge and during a 6-month follow-up.
RESULTS:All procedures were successfully completed with no early mortality. At 6 months, the TPVR group demonstrated significantly lower pulmonary valve transvalvular pressure gradients compared to the SPVR group (P<0.05). Both groups exhibited significant improvements from baseline in New York Heart Association (NYHA) functional class, biventricular ejection fractions, and right ventricular end-diastolic volume index (all P<0.05). The reduction in right ventricular end-diastolic diameter differed between the two groups (P<0.01). However, multivariable analysis revealed no association between this difference and surgical approach (β=4.4, P>0.05). In the TPVR group, QRS duration was significantly shortened postoperatively (P<0.01), with improvements in left ventricular end-diastolic volume index and cardiac index (both P<0.01), but these improvements did not differ significantly from the SPVR group (all P>0.05). During the follow-up, one patient in each group developed infective endocarditis within 1-month post-procedure; both were successfully treated with antibiotics. No other major complications were observed.
CONCLUSIONS:For patients with moderate-to-severe pulmonary regurgitation and RVSD, TPVR using the Venus-P valve effectively improves short-term pulmonary valve function and ventricular performance with a favorable safety profile, demonstrating potential as a minimally invasive alternative to SPVR .
