title: Will catheter interventions replace surgery for valve abnormalities?
abstract: OBJECTIVE
  Catheter-based valve technologies have evolved rapidly over the last decade. Transcatheter aortic valve replacement (TAVR) has become a routine procedure in high-risk adult patients with calcific aortic stenosis. In patients with congenital heart disease (CHD), transcatheter pulmonary valve replacement represents a transformative technology for right ventricular outflow tract dysfunction with the potential to expand to other indications. This review aims to summarize the current state-of-the-art for transcatheter valve replacement (TVR) in CHD; the expanding indications for TVR; and the technological obstacles to optimizing TVR.
  
  
  RESULTS
  Multiple case series have demonstrated that TVR with the Melody transcatheter pulmonary valve in properly selected patients is safe, effective, and durable in short-term follow-up. The Sapien transcatheter heart valve represents an alternative device with similar safety and efficacy in limited studies. Innovative use of current valves has demonstrated the flexibility of TVR, while highlighting the need for devices to address the broad range of postoperative anatomies either with a single device or with strategies to prepare the outflow tract for subsequent device deployment.
  
  
  CONCLUSIONS
  The potential of TVR has not been fully realized, but holds promise in treatment of CHD.
authors.affiliation: Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: O'Byrne
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gillespie
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000601:surgery*; D016896:Treatment Outcome