2024 Statement from Asia expert operators on transcatheter pulmonary valve replacement

2024 Statement from Asia expert operators on transcatheter pulmonary valve replacement

Ming C. Leong

Mohd Norazmi Nordin, Yusmi bin Mohd Yunus, Murugan Rajoo, Siti Sarah Maidin, Mohd Saleh Abbas, Mohamad Maulana Magiman, Nor Fauziyana Mosbiran. Applications of Multiple Musical Intelligence in Learning Process of Special Education Needs Student with Hearing Impairment. Afr J Bio Sc. Feb 2024;6(6):252-257

Transcatheter pulmonary valve replacement (TPVR), a minimally invasive procedure, has been applied to over 20,000 patients worldwide, offering a less traumatic alternative to surgical valve replacement with shorter recovery times

Background

This article discusses a medical procedure called Transcatheter Pulmonary Valve Replacement (TPVR). This is a minimally invasive method to replace a damaged pulmonary valve in the heart without open-heart surgery. Instead of cutting open the chest, doctors use a thin tube called a catheter to deliver a new valve to the heart through blood vessels.

Why is TPVR Important?

Traditional Surgery vs. TPVR: Traditional surgery to replace the pulmonary valve can be quite invasive, requiring the chest to be opened and the heart to be stopped. TPVR, on the other hand, is less invasive and can be done while the heart is still beating, leading to faster recovery and fewer complications. Who Needs TPVR?: This procedure is typically needed for patients who have had previous surgeries to correct congenital heart defects (like Tetralogy of Fallot) that cause problems in the right ventricular outflow tract (RVOT), which is a part of the heart that directs blood flow to the lungs.

Key Findings:

Improved Symptoms and Function: TPVR helps improve symptoms related to heart problems, like difficulty exercising, heart failure, and irregular heartbeats. It also helps the heart function better by reducing the volume overload in the right ventricle (the heart’s right lower chamber).

Choosing the Right Valve: There are different types of valves used in TPVR, including balloon-expandable and self-expandable valves. The choice depends on the patient’s specific heart structure and previous surgeries.

When to Use TPVR: TPVR is recommended for patients with moderate to severe pulmonary regurgitation (leakage of blood back into the heart due to a faulty valve) or RVOT obstruction (blockage) who have symptoms or specific heart measurements indicating poor heart function. It is also preferred for patients who are suitable based on their heart anatomy. If not suitable, traditional surgery might be considered.

Devices and Innovations: Various devices used in TPVR include Melody, Sapien, Harmony, and Venus-P valves. Each has different characteristics and is chosen based on the patient’s needs. Newer devices and techniques are continually being developed to improve the outcomes of TPVR.