[III-JCKAP7-1-3] Update of percutaneous pulmonary valve replacement for pediatric heart patients with RVOT disease
Keywords:congenital heart disease, children, growth
Surgical pulmonary valve replacement (PVR) has been gold standard to treat pulmonary valve problems for several decades. Though surgical PVR has shown good outcomes, majority of surgical treatment is in the direction of innovative and collaborative hybrid procedures, and even percutaneous PVR to minimize mortality, morbidity, and hospital stay. Since the introduction of percutaneous PVR in 2000 by Bonhoeffer et al., balloon-expandable percutaneous pulmonary valve systems such as the Melody and Edwards SAPIEN transcatheter valves have been successfully used in the surgically implanted pulmonary valves with good clinical outcome. However, most patients with a dilated native RVOT with significant PR need a larger valved-stent for stable valve position. For this reason, a single self-expandable system for percutaneous PVR has been developed. First successful implantation of a self-expandable valve into a dilated pulmonary trunk was reported in 2010 by Schievano et al., and this Harmony valve was recently approved by US FDA on March 2021. Other self-expandable valve for a dilated pulmonary trunk is the Venus-P Valve, which was acquired CE approval on March 2022. Pulsta valve, developed in South Korea, is also another option for the native RVOT lesion and received market approval in South Korea in Sep. 2019 and CE approval clinical trial was completed on January 2022. These self-expandable transcatheter valve systems will be definitely next-generation PVR method in the native RVOT lesions after various congenital heart disease treatment.