VenusP-Valve: Outcomes Beyond 5 Years.

BACKGROUND

Percutaneous pulmonary valve implantation (PPVI) is an alternative to surgery for dysfunctional right ventricular outflow tracts (RVOTs). The VenusP-valve is a self-expanding transcatheter valve, available in diameters from 24 to 36 mm, and is designed for use in the larger RVOTs.

AIMS: A retrospective review to evaluate the medium to long-term results of the VenusP-valve, focusing on patient outcomes and durability of the valve.

METHODS

Between October 2013 and September 2018, 58 patients with severe pulmonary regurgitation (PR) underwent attempted PPVI with the VenusP-valve at Evelina London Children's Hospital, London, UK, and Pediatric Heart Center, Queen Sirikit National Institute of Child Health, Bangkok, Thailand. Data on patient characteristics, clinical and imaging outcomes, and follow-up status were collected retrospectively.

RESULTS

During the studied period, 56 (96.6%) patients had a successful PPVI out of 58 attempted procedures. One attempt was unsuccessful, and one patient experienced valve migration, both requiring surgical intervention. There were no early or late deaths, and no patients developed valve stenosis or severe PR. Additionally, none of the patients experienced infective endocarditis or significant ventricular arrhythmias. Fluoroscopic evaluation at 6-12 months revealed wire frame fractures in 13 patients (23.2%), typically in the proximal flare of the valve; however, these fractures did not affect the valve function. Atrial arrhythmias occurred in two patients (3.5%), one of whom was managed medically and the other underwent successful ablation. The cohort of patients showed a significant decrease in PR on transthoracic echocardiography and a significant reduction in indexed right ventricular end-diastolic volumes and pulmonary regurgitant fraction by cardiac magnetic resonance imaging at between 6 and 12 months. These results were sustained on serial follow-up.

CONCLUSION

VenusP-valve implantation is associated with excellent early and mid-term outcomes over a 5-10 year period, with no major complications related to valve function. However, longer-term follow-up is required to further assess its performance and longevity.