ABSTRACT
Introduction: As with any bioprosthetic valve, bioprosthetic valves in the pulmonary position have a finite life span and patients with bioprosthetic pulmonary valves require lifetime management to treat valve dysfunction.
Areas covered: In this article, authors discuss the current medical management for the treatment of dysfunctional bioprosthetic valves. This review is based on both an extensive review of the recent cardiac surgical/interventional cardiology literature (PubMed and MEDLINE database searches from 1958 to 2019) and personal experience.
Expert opinion: Valve technology is rapidly progressing and with a coordinated effort from cardiac surgeons and interventional cardiologists, patients suffering from bioprosthetic pulmonary valve dysfunction can expect to have a decreased number of procedures and less invasive procedures over their lifetime now.
Article highlights
Patients with congenital heart disease and other pulmonary valve problems require frequent pulmonary valve replacements over their lifetime.
There are currently a number of surgical bioprosthetic valves at the disposal of the surgeon for pulmonary valve replacement with a variety of distinguishing features.
Transcatheter pulmonary valve replacement has emerged as an approved and effective modality for the treatment of dysfunctional bioprosthetic pulmonic valves.
New transcatheter-based techniques such as intentional fracture of the bioprosthetic frame may result in the placement of larger diameter transcatheter pulmonary valves..
Declaration of interest
Athar M. Qureshi, MD is a consultant for W.L. Gore and Edwards Lifesciences. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
Reviewer disclosures
A reviewer on this manuscript has disclosed that they are a Proctor and Consultant for Medtronic Inc. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.