Current clinical management of dysfunctional bioprosthetic pulmonary valves

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.

KEYWORDS:

• Bioprosthetic
• pulmonary valve
• surgical bioprosthetic pulmonary valve placement
• transcatheter pulmonary valve
• intentional frame fracture

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.

Additional information

Funding

This paper was not funded.