Pulsta Valve, Unique Self-Expandable Transcatheter Pulmonary Valve.

Large sized valve of a self-expandable nature has been suggested as the next generation transcatheter pulmonary valve to implant for various type of native right ventricular outflow tract (RVOT) lesions. Tissue engineered Pulsta valve including decellularization, alpha-galactosidase treatment provide longer valve durability and knitted woven nitinol wire stent provide low risk of stent fracture at the dynamic RVOT. Compact tubular design of Pulsta valve also offer easy valve loading to delivery system and good trackability to valve landing area. From the worldwide experience over 750 cases by February 2025, adaptability of Pulsta valve for various RVOT has proven. Pulsta valve has been implanted for various type of main pulmonary artery (PA) including pyramidal, reverse pyramidal shape and for branch PA stenosis including stent in the branch PA. In case of extremely large native RVOT anatomy, Pulsta valve can be implanted in both branch PA respectively. For the stenotic RVOT or failed bioprosthetic valve, Pulsta valve can also be implanted with or without pre-stenting. Recapturability using delivery system itself if less than one third of valve were flared outside of sheath and capability of whole delivery system retrieval using hooking system are another merit for safe procedure. Though the experience of Pulsta valve for various RVOT diseases is newly accumulated in many centers every day, we still have to learn more about Pulsta valve applicability for various RVOT diseases and long-term outcomes after Pulsta valve implantation.