The purpose of this study is to evaluate the safety and short-term effectiveness of implantation of Transcatheter Pulmonary Valve (TPV) for the treatment of congenital heart disease with pulmonary valve disease.
Diverse congenital heart diseases involving the pulmonary artery, such as Tetralogy of Fallot (TOF) with or without pulmonary atresia, or transposition of the great arteries with pulmonary stenosis, require implantation of an artificial conduit between the right ventricle and the pulmonary artery(PA). Because these conduits finally degenerate and result in pulmonary regurgitation and/or stenosis and progressive right ventricle (RV) dilation and eventual failure, patients need repetitive surgery for conduit revision. Transcatheter pulmonary valve implantation (TPVI) is a less invasive alternative to surgery in patients with dysfunctional right ventricular outflow tract (RVOT). TPV is a large-diameter (up to 28 mm) self-expandable stent with a relatively low profile from a nitinol wire backbone with valve leaflets made from porcine pericardial tissue. The TPV is indicated for use in patients with previous undergone replacement of bioprosthetic valve or conduit due to either pulmonary valve atresia, stenosis, regurgitation or a combination of them and present with dysfunctional RVOT requiring treatment for severe pulmonary regurgitation and/or RVOT conduit obstruction. Consecutive subject data should be collected at discharge, 1, 3, 6 month, and 1-5 years post TPV implantation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
Transcatheter Pulmonary Valve Replacement
Seoul National University Hospital
Seoul, Haehak-ro Jongno-gu, South Korea
Procedural success
Procedural success is defined as the TPV implant within desired position, RV-PA peak systolic pressure gradient \<35mmHg by catheter, less mild pulmonary regurgitation by angiography, and freedom from explantation of the TPV at 24 hours post-implant.
Time frame: 5day
Hemodynamic functional improvement at 6month
Hemodynamic functional improvement is defined as mean RVOT gradient ≤30 mmHg by continuous wave doppler, and a pulmonary regurgitant fraction \<20% by cardiac magnetic resonance (MR).
Time frame: 6 month
Procedural / Device related serious adverse events at 6month
Time frame: 6 month
Hemodynamic function
Hemodynamic function will be measured including peak RVOT pressure gradient, mean RVOT pressure gradient, RV-PA pressure gradient, RV pressure, cardiac output, cardiac index, RV end-diastolic volume by echocardiography, cardiac MR, or catheterization.
Time frame: 5 year
Severity of pulmonary regurgitation
Time frame: 5year
Pulmonary regurgitant fraction
Time frame: 5year
New York Heart Association (NYHA) functional classification
Time frame: 5 year
Stent fracture
Time frame: 5 year
Catheter reintervention on TPV
Time frame: 5 year
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Reoperation
Time frame: 5 year
Procedural / Device related serious adverse events
Time frame: 5 year
Death (all cause / procedural / device-related)
Time frame: 5 year
Other adverse events
Time frame: 5 year