Canadian Journal of Cardiology
Clinical Research|Articles in Press

Self-Expanding Pulmonary Valves in Fifty-Three Patients with Native Repaired Right Ventricular Outflow Tracts

Published:March 16, 2023DOI:



      Self-expanding pulmonary valve grafts have been designed for percutaneous pulmonary valve implantation (PPVI) in patients with native repaired right ventricular (RV) outflow tracts (RVOTs). However, their efficacy, in terms of RV function, and graft remodeling remain unclear.


      Patients with native RVOTs who received Venus P-valve (N=15) or Pulsta valve (N=38) implants between 2017 and 2022 were enrolled. We collected data on patient characteristics and cardiac catheterization parameters as well as imaging and laboratory data before, immediately after, and 6–12 months after PPVI and identified risk factors for RV dysfunction.


      Valve implantation was successful in 98.1% of patients. The median duration of follow-up was 27.5 months. In the first 6 months after PPVI, all patients exhibited a resolution of paradoxical septal motion and a significant reduction (P < 0.05) in RV volume, N-terminal pro-B-type natriuretic peptide levels, and valve eccentricity indices (−3.9%). Normalization of the RV ejection fraction (≥ 50%) was detected in only 9 patients (17.3%) and was independently associated with the RV end-diastolic volume index prior to PPVI (P = 0.03). Nine patients had residual or recurrent pulmonary regurgitation or paravalvular leak (graded as ≧mild), which was associated with a larger eccentricity index (>8%) and subsided by 12 months post-implantation.


      We identified the risk factors likely to be associated with RV dysfunction and pulmonary regurgitation following PPVI in patients with native repaired RVOTs. RV volume-based patient selection is recommended for PPVI of a self-expanding pulmonary valve, along with monitoring of graft geometry.

      Graphical abstract


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