Purpose of review
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.
Recent findings
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.
Summary
The potential of TVR has not been fully realized, but holds promise in treatment of CHD.
