The adaptability of the Pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease.
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Journal Volume
103
Journal Issue
4
Start Page
587
End Page
596
ISSN
1522-726X
Date Issued
2024-03
Author(s)
Park, Woo Young
Kim, Gi Beom
Lee, Sang Yun
Kim, Ah Young
Choi, Jae Young
Jang, So Ick
Kim, Seong Ho
Cha, Seul Gi
Abstract
BACKGROUND: Pulsta valve is increasingly used for percutaneous pulmonary valve implantation (PPVI) in patients with a large native right ventricular outflow tract (RVOT). This study aims to elucidate the outcomes of Pulsta valve implantation within the native RVOT and assess its adaptability to various native main pulmonary artery (PA) anatomies. METHODS: A multicenter retrospective study included 182 patients with moderate to severe pulmonary regurgitation in the native RVOT who underwent PPVI with Pulsta valves? between February 2016 and August 2023 at five Korean and Taiwanese tertiary referral centers. RESULTS: after 1 year. The main PA types were classified as pyramidal (3.8%), straight (38.5%), reverse pyramidal (13.2%), convex (26.4%), and concave (18.1%) shapes. Pulsta valve placement was adapted, with distal main PA for pyramidal shapes and proximal or mid-PA for reverse pyramidal shapes. Two patients experienced Pulsta valve embolization to RV, requiring surgical removal, and one patient encountered valve migration to the distal main PA, necessitating surgical fixation. CONCLUSIONS: Customized valve insertion sites are pivotal in self-expandable PPVI considering diverse native RVOT shape. The rather soft and compact structure of the Pulsta valve has characteristics to are adaptable to diverse native RVOT geometries.
Subjects
congenital heart disease
native right ventricular outflow tract type
percutaneous pulmonary valve implantation
pulmonary regurgitation
Type
journal article