Expanding Valves, Expanding Options: The Growing Armamentarium for Treatment of the Surgically Repaired Right Ventricular Outflow Tract in Tetralogy of Fallot.

Since the first-in-human transcatheter heart valve implantation in 2000 in the pulmonary position– a prototype of what would eventually become the Melody valve (Medtronic, Minneapolis, MN, USA) 1 Bonhoeffer P. Boudjemline Y. Saliba Z. et al. Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet. 2000; 356: 1403-1405 Abstract Full Text Full Text PDF PubMed Google Scholar – the field of transcatheter pulmonary valve replacement (TPVR) has come full circle. Balloon-expandable valves have long met a critical need among patients with dysfunctional right ventricle (RV) to pulmonary artery conduits and surgical bioprosthetic valves. With time, new devices, and increasing expertise, selected patients with surgically repaired right ventricular outflow tracts (RVOT) could be treated with the largest balloon expandable valves with an upper limit of 29-30 mm. This left behind a substantial population of patients not eligible for TPVR. Self-Expanding Pulmonary Valves in Fifty-Three Patients with Native Repaired Right Ventricular Outflow TractsCanadian Journal of CardiologyPreviewSelf-expanding pulmonary valve grafts have been designed for percutaneous pulmonary valve implantation (PPVI) in patients with native repaired right ventricular (RV) outflow tracts (RVOTs). However, their efficacy, in terms of RV function, and graft remodeling remain unclear. Full-Text PDF