Abstract
Percutaneous pulmonary valve implantation (PPVI) remains technically challenging. We describe the early results of PPVI with the SAPIEN 3 (S3) valve facilitated by a large delivery sheath. We designed a prospective, single cohort study. Between December 2017 and April 2018, 16 patients (median age 24 y/o; median weight 70 kg) underwent PPVI with the SAPIEN 3 using a 65 cm, 26Fr GORE® DrySeal delivery sheath. Through the sheath, the landing zone was stented, then the valve implanted during the same procedure. PPVI was performed on native or patched outflow tract in 75.0% of patients. Pre-stenting was performed in 13 cases (81.3%). While advancing the sheath through the stent, stent migration occurred in one case. The stent was moved back and PPVI performed. Size 23, 26 and 29 valves were successfully implanted in 2, 3 and 11 cases, respectively. Median post valve gradient was 2 mmHg. Minor paravalvular leak was reported in 2 cases. Median fluoroscopy time was 18 min. Vessel access minimal hematomas and vessel access delayed healing were reported in 4 cases (25.0%) and in one case (6.3%) without any secondary procedure or blood transfusion. A large delivery sheath allows a fast and safe PPVI with the S3 valve.
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