[Short-term outcomes of transcatheter pulmonary valve replacement with Venus-P valve in patients with moderate-to-severe pulmonary regurgitation and right ventricular systolic dysfunction].

OBJECTIVES

To evaluate the short-term outcomes of transcatheter pulmonary valve replacement (TPVR) using the Venus-P valve in patients with moderate-to-severe pulmonary regurgitation and right ventricular systolic dysfunction (RVSD) following surgical repair of complex congenital heart disease.

METHODS

A retrospective analysis was conducted on patients undergoing Venus-P valve implantation (TPVR group, =28) or surgical pulmonary valve replacement (SPVR group, =19) at Fuwai Hospital between February 2014 and February 2024. All patients had moderate-to-severe pulmonary regurgitation with right ventricular ejection fraction less than 45% preoperatively. Postoperative pulmonary valve function and ventricular parameters were assessed at discharge and during a 6-month follow-up.

RESULTS

All procedures were successfully completed with no early mortality. At 6 months, the TPVR group demonstrated significantly lower pulmonary valve transvalvular pressure gradients compared to the SPVR group (<0.05). Both groups exhibited significant improvements from baseline in New York Heart Association (NYHA) functional class, biventricular ejection fractions, and right ventricular end-diastolic volume index (all <0.05). The reduction in right ventricular end-diastolic diameter differed between the two groups (<0.01). However, multivariable analysis revealed no association between this difference and surgical approach (=4.4, >0.05). In the TPVR group, QRS duration was significantly shortened postoperatively (<0.01), with improvements in left ventricular end-diastolic volume index and cardiac index (both <0.01), but these improvements did not differ significantly from the SPVR group (all >0.05). During the follow-up, one patient in each group developed infective endocarditis within 1-month post-procedure; both were successfully treated with antibiotics. No other major complications were observed.

CONCLUSIONS

For patients with moderate-to-severe pulmonary regurgitation and RVSD, TPVR using the Venus-P valve effectively improves short-term pulmonary valve function and ventricular performance with a favorable safety profile, demonstrating potential as a minimally invasive alternative to SPVR .