title: Percutaneous pulmonary valve implantation with the Venus P-valve: clinical experience and early results.
abstract: BACKGROUND
  At present, the exclusion for percutaneous pulmonary valve implantation for free pulmonary regurgitation after tetralogy of Fallot repair includes an unfavourably large right ventricular outflow tract.
  
  
  OBJECTIVE
  To report feasibility and early experience with a recently developed transcatheter heart valve, Venus P-valveTM, implanted in six patients with severe pulmonary regurgitation with large right ventricular outflow tracts. Patients There were two female patients and four male patients. The median age of the patients was 18.5 years, and the mean body weight was 53.8 kg. All the patients were in NYHA class II and had severe pulmonary regurgitation after previous transannular patch repair of tetralogy of Fallot. The median time after the last surgical operation was 13.5 years.
  
  
  RESULTS
  The Venus P-valveTM was successfully implanted in all the patients with implanted valve diameters ranging from 24 to 32 mm. The mean fluoroscopy time was 29.8 minutes. None of the patients had significant outflow tract gradient or pulmonary regurgitation immediately after valve implantation. Only one patient had unexpected mild proximal valve migration to the right ventricular body during withdrawal of the delivery system. It caused mild paravalvar leak and significant tricuspid regurgitation. At 6 months follow-up, the median of right ventricular end-diastolic volume indices decreased from 146 to 108 ml/m2 (p-value=0.046). The Doppler systolic peak gradient across the valve ranged from 4 to 40 mmHg, and there was no evidence of stent fracture on fluoroscopy or structural valve failure.
  
  
  CONCLUSIONS
  The Venus P-valveTM can be implanted successfully and effectively in patients with severe pulmonary regurgitation and a large right ventricular outflow tract. The early results with this valve are encouraging.
authors.affiliation: 1Pediatric Heart Center,Queen Sirikit National Institute of Child Health,College of Medicine,Rangsit University,Bangkok,Thailand.
authors.forename: Worakan
authors.initials: W
authors.lastname: Promphan
authors.affiliation: 1Pediatric Heart Center,Queen Sirikit National Institute of Child Health,College of Medicine,Rangsit University,Bangkok,Thailand.
authors.forename: Pimpak
authors.initials: P
authors.lastname: Prachasilchai
authors.affiliation: 3Department of Paediatric Cardiology,Evelina London Children's Hospital,Guy's and St Thomas' NHS Foundation Trust,London,United Kingdom.
authors.forename: Suvipaporn
authors.initials: S
authors.lastname: Siripornpitak
authors.affiliation: 2Department of Radiology, Faculty of Medicine,Ramathibodi Hospital,Mahidol University,Bangkok,Thailand.
authors.forename: Shakeel A
authors.initials: SA
authors.lastname: Qureshi
authors.affiliation: 1Pediatric Heart Center,Queen Sirikit National Institute of Child Health,College of Medicine,Rangsit University,Bangkok,Thailand.
authors.forename: Thanarat
authors.initials: T
authors.lastname: Layangool
mesh_terms: D000293:Adolescent; D004867:Equipment Design; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Pulmonary regurgitation; Venus P-valveTM; percutaneous pulmonary valve implantation