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Transcatheter pulmonary valve replacement
Transcatheter pulmonary valve replacement (TPVR), also known as percutaneous pulmonary valve implantation (PPVI), is the replacement of the pulmonary valve via catheterization through a vein. It is a significantly less invasive procedure in comparison to open heart surgery and is commonly used to treat conditions such as pulmonary atresia.
TPVR can be used to repair congenital defects in the pulmonary valve or right ventricular outflow tract dysfunction, such as pulmonary atresia, Tetralogy of Fallot, or persistent truncus arteriosus. TPVR can also be used to replace dysfunctional artificial heart valves.
For those experiencing symptoms, TPVR is indicated when the right ventricular systolic pressure is above 60 mmHg and/or when there is moderate to severe pulmonary regurgitation. For those not experiencing any symptoms, TPVR is indicated if there is severe right ventricular outflow tract narrowing and/or severe pulmonary insufficiency, with decreased exercise capacity, progressive right ventricular dilation, progressive right ventricular dysfunction, progressive tricuspid valve regurgitation, right ventricular systolic pressure above 80 mmHg, or cardiac fibrillation.
For dysfunctional artificial conduits, TPVR immediately resolves pulmonary regurgitation and normalizes the right ventricular outflow tract gradient, and is associated with significant improvements in symptoms and improvements in long-term ventricular function.
Active infection, central vein occlusion, coronary occlusion, and need for other surgeries such as for arrhythmia are contraindications for TPVR.
If coronary compression (which impairs coronary blood flow) is observed with balloon dilation in the right ventricular outflow tract, TPVR is also contraindicated. This test is performed to prevent potentially fatal complications, for which approximately 5% of candidates are at risk.
TPVR is not recommended for tracts that are less than 16 mm or more than 29 mm in diameter.
There is a low incidence of major complications, which is likely due to pre-procedural assessments preventing individuals with unfavourable anatomy from undergoing the procedure.
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Transcatheter pulmonary valve replacement
Transcatheter pulmonary valve replacement (TPVR), also known as percutaneous pulmonary valve implantation (PPVI), is the replacement of the pulmonary valve via catheterization through a vein. It is a significantly less invasive procedure in comparison to open heart surgery and is commonly used to treat conditions such as pulmonary atresia.
TPVR can be used to repair congenital defects in the pulmonary valve or right ventricular outflow tract dysfunction, such as pulmonary atresia, Tetralogy of Fallot, or persistent truncus arteriosus. TPVR can also be used to replace dysfunctional artificial heart valves.
For those experiencing symptoms, TPVR is indicated when the right ventricular systolic pressure is above 60 mmHg and/or when there is moderate to severe pulmonary regurgitation. For those not experiencing any symptoms, TPVR is indicated if there is severe right ventricular outflow tract narrowing and/or severe pulmonary insufficiency, with decreased exercise capacity, progressive right ventricular dilation, progressive right ventricular dysfunction, progressive tricuspid valve regurgitation, right ventricular systolic pressure above 80 mmHg, or cardiac fibrillation.
For dysfunctional artificial conduits, TPVR immediately resolves pulmonary regurgitation and normalizes the right ventricular outflow tract gradient, and is associated with significant improvements in symptoms and improvements in long-term ventricular function.
Active infection, central vein occlusion, coronary occlusion, and need for other surgeries such as for arrhythmia are contraindications for TPVR.
If coronary compression (which impairs coronary blood flow) is observed with balloon dilation in the right ventricular outflow tract, TPVR is also contraindicated. This test is performed to prevent potentially fatal complications, for which approximately 5% of candidates are at risk.
TPVR is not recommended for tracts that are less than 16 mm or more than 29 mm in diameter.
There is a low incidence of major complications, which is likely due to pre-procedural assessments preventing individuals with unfavourable anatomy from undergoing the procedure.