Transcatheter pulmonary valve-in-valve implantation

Amr Matoq, Shabana Shahanavaz

Surgically placed Bioprosthetic Valves (BPV) are widely used in the pulmonary position for dysfunctional Right Ventricular Outflow Tract (RVOT) in patients with Tetralogy of Fallot (TOF) as well as other conotruncal anomalies. The longevity of BPV in the pulmonary position is variable with inevitable dysfunction secondary to calcification, leaflet thickening, and subclinical thrombosis. Surgical replacement of dysfunctional BPV has been largely replaced by Transcatheter Pulmonary Valve (TPV) implantation, using the BPV frame as a landing zone, i.e., Valve-in-Valve (VIV) with good outcomes that are comparable to surgical valve replacement. In this mini review, we summarize outcomes, limitations, and technical considerations for transcatheter VIV implantation in the pulmonary position.