Transcatheter Pulmonary Valve Replacement With the Edwards Sapien System: The Toronto Experience.

JACC Cardiovasc Interv. 2015 Dec 21;8(14):1819-27. doi: 10.1016/j.jcin.2015.08.016.

Transcatheter Pulmonary Valve Replacement With the Edwards Sapien System: The Toronto Experience.
 

Wilson WM1Benson LN2Osten MD1Shah A1Horlick EM3.

Comment by Konstantin Averin

Abstract

In this study Wilson and colleagues sought to review their experience with the Sapien and Sapien XT valves for percutaneous pulmonary valve implantation (PPVI). The authors retrospectively collected procedural and follow up data on 25 patients who underwent PPVI from 2007 – 2014. A majority of patients had undergone either palliation for TOF or a Ross procedures. The procedure was technically successful in 96% of cases. Pre-stenting was performed in all cases, with half of the patients receiving a covered stent to minimize post-procedural pulmonary regurgitation. Valve sizes were 23mm (8), 26mm (15) and 29mm (2) with the newer Sapien XT valve being used in 4 cases. No patients underwent implantation in a native outflow tract. Procedural hemodynamics (including RV-systemic pressure ratio and RVOT gradient) after valve implantation were significantly improved. At a mean follow-up 3.5 years there were no deaths and only 1 patient required reintervention.  The authors conclude that the Edwards Sapien system is a viable and duration option for PPVI. Compared to the more established Melody valve (which is suitable for outflow tracts smaller than 24mm), the Edwards Sapien system has the potential to expand the use of PPVI to patients with outflow tracts as large as 29mm.