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Pulmonic Valve Disease: Review of Pathology and Current Treatment Options.

Publication ,  Journal Article
Fathallah, M; Krasuski, RA
Published in: Curr Cardiol Rep
September 16, 2017

PURPOSE OF REVIEW: Our review is intended to provide readers with an overview of disease processes involving the pulmonic valve, highlighting recent outcome studies and guideline-based recommendations; with focus on the two most common interventions for treating pulmonic valve disease, balloon pulmonary valvuloplasty and pulmonic valve replacement. RECENT FINDINGS: The main long-term sequelae of balloon pulmonary valvuloplasty, the gold standard treatment for pulmonic stenosis, remain pulmonic regurgitation and valvular restenosis. The balloon:annulus ratio is a major contributor to both, with high ratios resulting in greater degrees of regurgitation, and small ratios increasing risk for restenosis. Recent studies suggest that a ratio of approximately 1.2 may provide the most optimal results. Pulmonic valve replacement is currently the procedure of choice for patients with severe pulmonic regurgitation and hemodynamic sequelae or symptoms, yet it remains uncertain how it impacts long-term survival. Transcatheter pulmonic valve replacement is a rapidly evolving field and recent outcome studies suggest short and mid-term results at least equivalent to surgery. The Melody valve® was FDA approved for failing pulmonary surgical conduits in 2010 and for failing bioprosthetic surgical pulmonic valves in 2017 and has been extensively studied, whereas the Sapien XT valve®, offering larger diameters, was approved for failing pulmonary conduits in 2016 and has been less extensively studied. Patients with pulmonic valve disease deserve lifelong surveillance for complications. Transcatheter pulmonic valve replacement is a novel and attractive therapeutic option, but is currently only FDA approved for patients with failing pulmonary conduits or dysfunctional surgical bioprosthetic valves. New advances will undoubtedly increase the utilization of this rapidly expanding technology.

Duke Scholars

Published In

Curr Cardiol Rep

DOI

EISSN

1534-3170

Publication Date

September 16, 2017

Volume

19

Issue

11

Start / End Page

108

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Recurrence
  • Pulmonary Valve Stenosis
  • Pulmonary Valve Insufficiency
  • Pulmonary Valve
  • Humans
  • Heart Valve Prosthesis Implantation
  • Heart Valve Diseases
  • Cardiovascular System & Hematology
 

Citation

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Fathallah, M., & Krasuski, R. A. (2017). Pulmonic Valve Disease: Review of Pathology and Current Treatment Options. Curr Cardiol Rep, 19(11), 108. https://doi.org/10.1007/s11886-017-0922-2
Fathallah, Mouhammad, and Richard A. Krasuski. “Pulmonic Valve Disease: Review of Pathology and Current Treatment Options.Curr Cardiol Rep 19, no. 11 (September 16, 2017): 108. https://doi.org/10.1007/s11886-017-0922-2.
Fathallah M, Krasuski RA. Pulmonic Valve Disease: Review of Pathology and Current Treatment Options. Curr Cardiol Rep. 2017 Sep 16;19(11):108.
Fathallah, Mouhammad, and Richard A. Krasuski. “Pulmonic Valve Disease: Review of Pathology and Current Treatment Options.Curr Cardiol Rep, vol. 19, no. 11, Sept. 2017, p. 108. Pubmed, doi:10.1007/s11886-017-0922-2.
Fathallah M, Krasuski RA. Pulmonic Valve Disease: Review of Pathology and Current Treatment Options. Curr Cardiol Rep. 2017 Sep 16;19(11):108.
Journal cover image

Published In

Curr Cardiol Rep

DOI

EISSN

1534-3170

Publication Date

September 16, 2017

Volume

19

Issue

11

Start / End Page

108

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Recurrence
  • Pulmonary Valve Stenosis
  • Pulmonary Valve Insufficiency
  • Pulmonary Valve
  • Humans
  • Heart Valve Prosthesis Implantation
  • Heart Valve Diseases
  • Cardiovascular System & Hematology