Current Treatment Options for Catheter-Based Pulmonary Valve Replacement in Children

Abstract

For decades, surgical replacement of the pulmonary valve has been the gold standard. The last 10 years have seen significant progress in improvement in the technology and techniques around percutaneous pulmonary valve Percutaneous pulmonary valve replacement (PPVR). This has allowed us to expand the range of patients who can be treated with percutaneous techniques. This review serves as an update for referring cardiologists. Several studies have demonstrated similar clinical outcomes comparing surgical and percutaneous valve replacement, noting the decreased recovery time and morbidity after PPVR. Along with the overall periprocedural advantages of PPVR, newer devices now allow pulmonary valve replacement in patients with surgically placed conduits and in patients with dilated native right ventricular outflow tracts (RVOT). PPVR is now also performed in smaller patients thanks to newly available techniques and technology. Imaging technology to guide these procedures has also evolved allowing such complex interventions to be performed with minimal radiation and contrast use in the catheterization laboratory. knowledge of technological advancements in PPVR will allow referring cardiologists and patients to make informed decisions about pulmonary valve replacement in each individual case. Technology will continue to evolve and hopefully provide many more surgical and percutaneous options to care for the congenital heart disease population.