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Percutaneous VenusP-valve implantation in the paediatric population

Published online by Cambridge University Press:  13 May 2025

Mohammad Ryan Abumehdi Open the ORCID record for Mohammad Ryan Abumehdi [Opens in a new window] ,
Matthew Jones ,
Naychi Lwin ,
Sophia Yong ,
Eric Rosenthal Open the ORCID record for Eric Rosenthal [Opens in a new window]  and
Shakeel Qureshi Open the ORCID record for Shakeel Qureshi [Opens in a new window]
Mohammad Ryan Abumehdi
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Matthew Jones
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Naychi Lwin
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Sophia Yong
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Eric Rosenthal
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
Shakeel Qureshi*
Affiliation:
Department of Paediatric Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
*
Corresponding author: Shakeel Qureshi; Email: shakeel.qureshi@gstt.nhs.uk
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Abstract

Objectives:

To assess short- and medium-term outcomes of VenusP-valve implantation in the pulmonary position in the paediatric population.

Background:

Percutaneous pulmonary valve implantation is now an established alternative to surgical pulmonary valve replacement, especially in those with conduits in the right ventricular outflow tract. The VenusP-valve™ (Venus Medtech, Shanghai, China) has demonstrated early efficacy in the adult population with larger conduit-free right ventricular outflow tracts. However, its use in children has not been well described.

Methods:

Retrospective review of patients under 18 years of age undergoing VenusP-valve implantation at a single institution between June 2015 and February 2023.

Results:

Fifteen patients under the age of 18 years underwent VenusP-valve™ implantation. All had severe pulmonary regurgitation and fulfilled accepted criteria for pulmonary valve implantation. Mean age at valve implantation was 14.1 (range 9.8–17.9) years, and mean weight was 54.9 (34.0–98.5) kg. The valve was deployed successfully in all the patients. The valve diameter and length ranged between 28–36 mm and 25–35 mm, respectively. Mean follow-up was 3.4 (0.5–8.1) years. At follow-up, twelve patients have undergone magnetic resonance imaging MRI as part of the regular surveillance. Indexed right ventricular end-diastolic volume improved from 157.8 (140.0–197.0) ml/m2 to 117.6 (91.0–152.0) ml/m2 (p = 0.004). Pulmonary regurgitation fraction had reduced from a mean of 44.3 (31.0–60.0) % to 3.6 (0.0–15.0) % (p = 0.003).

Conclusion:

This study demonstrates the safety and feasibility of the VenusP-valve implantation in children. Medium-term follow-up suggests that valve implantation is associated with a reduction in the degree of pulmonary regurgitation and right ventricular end-diastolic volume.

Keywords

Percutaneous pulmonary valve implantationvenusP-valvepercutaneous pulmonary valve implantationpaediatric intervention

Information

Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 6 , June 2025 , pp. 1145 - 1153
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

Bonhoeffer, P, Boudjemline, Y, Saliba, Z, et al. Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. The Lancet 2000; 356: 1403–1405.CrossRefGoogle Scholar
Endorsed by the Association for European Paediatric Cardiology (AEPC), Authors/Task Force Members, Baumgartner, H, Bonhoeffer, P, De Groot, NMS, de Haan, F, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010): The Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology (ESC). Eur Heart J 2010; 31: 2915–2957.Google Scholar
Eicken, A, Ewert, P, Hager, A, et al. Percutaneous pulmonary valve implantation: two-centre experience with more than 100 patients. Eur Heart J 2011; 32: 1260–1265.CrossRefGoogle ScholarPubMed
Morgan, G, Prachasilchai, P, Promphan, W, et al. Medium-term results of percutaneous pulmonary valve implantation using the venus P-valve: international experience. EuroIntervention 2019; 14: 1363–1370.CrossRefGoogle ScholarPubMed
Schievano, S, Coats, L, Migliavacca, F, et al. Variations in right ventricular outflow tract morphology following repair of congenital heart disease: implications for percutaneous pulmonary valve implantation. J Cardiovasc Magn Reson 2007; 9: 687–695.CrossRefGoogle ScholarPubMed
Jalal, Z, Valdeolmillos, E, Malekzadeh-Milani, S, et al. Mid-term outcomes following percutaneous pulmonary valve implantation using the, folded melody valve, technique. Circ Cardiovasc Interv 2021; 14: e009707.CrossRefGoogle ScholarPubMed
Hascoët, S, Bentham, JR, Giugno, L, et al. Outcomes of transcatheter pulmonary SAPIEN 3 valve implantation: an international registry. Eur Heart J 2024; 45: 198–210.CrossRefGoogle ScholarPubMed
Zablah, JE, Morgan, GJ. Current treatment options for catheter-based pulmonary valve replacement in children. Curr Treat Options Pediatr 2020; 6: 274–282.CrossRefGoogle Scholar
Husain, J, Praichasilchai, P, Gilbert, Y, Qureshi, SA, Morgan, GJ. Early european experience with the venus P-valve®: filling the gap in percutaneous pulmonary valve implantation. EuroIntervention J Eur Collab Work Group Interv Cardiol Eur Soc Cardiol 2016; 12: e643–e651.Google Scholar
Shahanavaz, S, Balzer, D, Babaliaros, V, et al. Alterra adaptive prestent and SAPIEN 3 THV for congenital pulmonic valve dysfunction. JACC Cardiovasc Interv 2020; 13: 2510–2524.CrossRefGoogle ScholarPubMed
Lee, S, Kim, GB, Kim, S, et al. Mid-term outcomes of the Pulsta transcatheter pulmonary valve for the native right ventricular outflow tract. Catheter Cardiovasc Interv [Internet] 2021; 98 (5): E724–E732. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ccd.29865.CrossRefGoogle ScholarPubMed
Promphan, W, Prachasilchai, P, Siripornpitak, S, Qureshi, SA, Layangool, T. Percutaneous pulmonary valve implantation with the venus P-valve: clinical experience and early results. Cardiol Young 2016; 26 ( 4 ): 698–710.CrossRefGoogle ScholarPubMed
Benson, LN, Gillespie, MJ, Bergersen, L, et al. Three-year outcomes from the harmony native outflow tract early feasibility study. Circ Cardiovasc Interv 2020; 13: e008320.CrossRefGoogle ScholarPubMed
Park, WY, Kim, GB, Lee, SY, et al. The adaptability of the pulsta valve to the diverse main pulmonary artery shape of native right ventricular outflow tract disease. Catheter Cardiovasc Interv 2024; 103: 587–596.Google Scholar
Cao, QL, Kenny, D, Zhou, D, et al. Early clinical experience with a novel self-expanding percutaneous stent-valve in the native right ventricular outflow tract: Venus P Valve for Rehabilitation of the RVOT in Patients with Chronic Severe PR. Catheter Cardiovasc Interv 2014; 84: 1131–1137.Google Scholar
Suradi, HS, Hijazi, ZM. Percutaneous pulmonary valve implantation. Glob Cardiol Sci Pract 2015; 2015: 23.CrossRefGoogle ScholarPubMed
Baumgartner, H, De Backer, J, Babu-Narayan, SV, et al. ESC guidelines for the management of adult congenital heart disease. Eur Heart J 2020; 42: 563–645.CrossRefGoogle Scholar
Stout, KK, Daniels, CJ, Aboulhosn, JA, et al. 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease. J Am Coll Cardiol 2019; 73: e81–e192.CrossRefGoogle ScholarPubMed
Garay, F, Pan, X, Zhang, YJ, Wang, C, Springmuller, D. Early experience with the venus pvalve for percutaneous pulmonary valve implantation in native outflow tract. Neth Heart J 2017; 25: 76–81.CrossRefGoogle ScholarPubMed
Bergersen, L, Benson, LN, Gillespie, MJ, et al. Harmony feasibility trial. JACC Cardiovasc Interv 2017; 10: 1763–1773.CrossRefGoogle ScholarPubMed
Cools, B, Budts, W, Heying, R, et al. Medium term follow-up after percutaneous pulmonary valve replacement with the melody® valve. IJC Heart Vasc 2015; 7: 92–97.CrossRefGoogle ScholarPubMed
Plessis, J, Hascoët, S, Baruteau, A, et al. Edwards SAPIEN transcatheter pulmonary valve implantation. JACC Cardiovasc Interv 2018; 11: 1909–1916.CrossRefGoogle ScholarPubMed
Kenny, D, Hijazi, ZM, Kar, S, et al. Percutaneous implantation of the edwards SAPIEN transcatheter heart valve for conduit failure in the pulmonary position. J Am Coll Cardiol 2011; 58: 2248–2256.CrossRefGoogle ScholarPubMed
Gillespie, MJ, McElhinney, DB, Jones, TK, Levi, DS, Asnes, J, Gray, RG, et al. 1-Year Outcomes in a Pooled Cohort of Harmony Transcatheter Pulmonary Valve Clinical Trial Participants. JACC Cardiovasc Interv 2023; 16: 1917–1928.CrossRefGoogle Scholar
Zablah, JE, Than, J, Browne, LP, Rodriguez, S, Morgan, GJ. Patient screening for self-expanding percutaneous pulmonary valves using virtual reality. J Am Heart Assoc 2024; 13: e033239.CrossRefGoogle ScholarPubMed
Kramer, P, Schleiger, A, Duong, P, Berger, F. Midterm experience with the self-expandable venus P-valveTM for percutaneous pulmonary valve replacement in large right ventricular outflow tracts. J Intervent Cardiol 2024; 2024: 1–9.CrossRefGoogle Scholar
Moore, JP, Aboulhosn, JA, Khairy, P. Electrophysiology testing before transcatheter pulmonary valve replacement in patients with repaired tetralogy of fallot. Eur Heart J 2023; 44: 3228–3230.CrossRefGoogle ScholarPubMed
Taylor, A, Yang, J, Dubin, A, et al. Ventricular arrhythmias following transcatheter pulmonary valve replacement with the harmony TPV25 device. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv 2022; 100: 766–773.Google ScholarPubMed
Barfuss, SB, Samayoa, JC, Etheridge, SP, et al. Ventricular arrhythmias following balloon-expandable transcatheter pulmonary valve replacement in the native right ventricular outflow tract. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv 2023. https://doi.org/10.1002/ccd.30560.Google ScholarPubMed
Zahn, EM, Hellenbrand, WE, Lock, JE, McElhinney, DB. Implantation of the melody transcatheter pulmonary valve in patients with a dysfunctional right ventricular outflow tract conduit. J Am Coll Cardiol 2009; 54: 1722–1729.CrossRefGoogle ScholarPubMed
Stefanescu Schmidt, AC, Armstrong, AK, Aboulhosn, JA, et al. Transcatheter pulmonary valve replacement with balloon-expandable valves. JACC Cardiovasc Interv 2024; 17: 231–244.CrossRefGoogle ScholarPubMed
Jin, Q, Long, Y, Zhang, G, et al. Five-year follow-up after percutaneous pulmonary valve implantation using the venus P-valve system for patients with pulmonary regurgitation and an enlarged native right ventricular outflow tract. Catheter Cardiovasc Interv 2024; 103: 359–366.Google Scholar
Nordmeyer, J, Khambadkone, S, Coats, L, et al. Risk stratification, systematic classification, and anticipatory management strategies for stent fracture after percutaneous pulmonary valve implantation. Circulation 2007; 115: 1392–1397.CrossRefGoogle ScholarPubMed
Akazawa, Y, Higaki, T, Kashiwagi, K, et al. Subclinical leaflet thrombosis after transcatheter pulmonary valve implantation: two clinical concerns. Circ Cardiovasc Imaging [Internet] 2024; 17 ( 6 ): e016459.Google ScholarPubMed
Hein, M, Schoechlin, S, Schulz, U, et al. Long-term follow-up of hypoattenuated leaflet thickening after transcatheter aortic valve replacement. JACC Cardiovasc Interv 2022; 15: 1113–1122.CrossRefGoogle ScholarPubMed
Garcia, S, Fukui, M, Dworak, MW, et al. Clinical Impact of Hypoattenuating Leaflet Thickening After Transcatheter Aortic Valve Replacement. Circ Cardiovasc Interv 2022; 15 ( 3): e011480.CrossRefGoogle ScholarPubMed
Pilati, M, Duong, P, Bordonaro, V, Secinaro, A, Butera, G. Auto-expandable pulmonary valve leaflet microthrombosis: a subtle and dangerous phenomenon. Eur Heart J - Cardiovasc Imaging 2023; 25: e56–e56.CrossRefGoogle ScholarPubMed
Iannaccone, G, Bautista-Rodriguez, C, Kacar, P, et al. Early failure of venusP-valve in pulmonary position: thrombosis and inflammation? JACC Cardiovasc Interv 2024; 17: 1738–1740.CrossRefGoogle ScholarPubMed