Department of Cardiology, King Faisal Cardiac Center, Ministry of National Guard Health Affair , Jeddah, Saudi Arabia.
Medical Research Department, King Abdullah International Medical Research Center , Jeddah, Saudi Arabia.
Expert Rev Med Devices. 2020 Jun;17(6):541-554. doi: 10.1080/17434440.2020.1775578.
Right ventricular outflow tract (RVOT) dysfunction is common among individuals with congenital heart disease (CHD). Surgical intervention often carries prohibitive risks due to the need for sequential pulmonary valve (PV) replacements throughout their life in the majority of cases. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with RVOT dysfunction.
In this review, we examine the pathophysiology of RVOT dysfunction, indications for tPVR, and the procedural aspect. Advancements in clinical application and valve technology will also be covered.
tPVR is widely accepted as an alternative to surgery to address RVOT dysfunction, but still significant numbers of patients with complex RVOT morphology deemed not suitable for tPVR. As the technology continues to evolve, new percutaneous valves will allow such complex RVOT patient to benefit from tPVR.
右心室流出道(RVOT)功能障碍在先天性心脏病(CHD)患者中很常见。由于大多数情况下需要在其一生中进行序贯肺动脉瓣(PV)置换,手术干预往往存在巨大风险。经导管肺动脉瓣置换术(tPVR)是 CHD 治疗中最近令人兴奋的进展之一,已发展成为 RVOT 功能障碍患者手术的一种有吸引力的替代方法。
在这篇综述中,我们研究了 RVOT 功能障碍的病理生理学、tPVR 的适应证以及手术方面。还将涵盖临床应用和瓣膜技术的进展。
tPVR 被广泛接受为解决 RVOT 功能障碍的手术替代方法,但仍有相当数量的 RVOT 形态复杂的患者被认为不适合 tPVR。随着技术的不断发展,新型经皮瓣膜将使这些复杂的 RVOT 患者受益于 tPVR。