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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Multicenter experience of hybrid transcatheter pulmonary valve implantation in patients with a large right ventricular outflow tract

  • Jun Dong1
  • Junwu Su1
  • Aijun Liu1
  • Shusheng Wen2
  • Taibing Fan3
  • Qi An4
  • Bing Jia5
  • Ming Ye5
  • Gangcheng Zhang6
  • Yongqiang Jin7
  • Yaxiong Li8
  • Cheng Zhou9
2 more authors
  • Baoshi Zheng10
  • Jing Xu11
11 affiliations
  1. 1Department of Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University
  2. 2Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital
  3. 3Department of Cardiovascular Surgery, Fuwai Central China Cardiovascular Hospital
  4. 4Department of Cardiovascular Surgery, West China Hospital, Sichuan University
  5. 5Department of Cardiovascular Surgery, Children’s Hospital of Fudan University
  6. 6Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University
  7. 7Department of Cardiovascular Surgery, Beijng Huaxin Hospital First Hospital of Tsinghua University
  8. 8Department of Cardiovascular Surgery, Kunming shi Yan'an Hospital
  9. 9Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
  10. 10Department of Cardiovascular Surgery, The First Affiliated Hospital of Guangxi Medical University
  11. 11Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University
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Abstract

Background: Management of pulmonary regurgitation (PR) in patients with a large and dysplastic native right ventricular outflow tract (RVOT) remains a significant challenge for percutaneous intervention. Given the limitations of percutaneous intervention in patients with a large and morphologically complex RVOT, this study aimed to evaluate the safety and efficacy of a hybrid transcatheter pulmonary valve implantation (TPVI) strategy using a self-expanding valve in this patient population.

Methods: Between June 2021 and December 2023, 102 patients with moderate-to-severe PR and dilated RVOT from 11 centers underwent hybrid TPVI with the Salus transcatheter pulmonary valve (TPV). Procedural strategies, including surgical access and concomitant procedures, were tailored based on comprehensive preoperative assessment.

Results: The mean age was 22.37 ± 11.15 years (range, 9–66), and 56.9% were male. The most common RVOT morphologies were pyramidal (37.2%) and tubular (30.4%). All procedures were successful. Twenty cases required cardiopulmonary bypass support. There were no intraoperative deaths. One in-hospital death occurred on postoperative day 12 in a high-risk patient with severe preoperative right ventricular dysfunction. All patients completed at least 1 year of follow-up, with a median follow-up duration of 1 year. During this period, significant improvements in right ventricular volumes (RVEDVI and RVESVI) and QRS duration were observed, whereas RVEF did not change significantly. There were no instances of coronary artery compression, valve embolization, or stent fracture. One suspected case of endocarditis was reported.

Conclusions: In patients with a large and morphologically complex RVOT, hybrid TPVI with the Salus TPV is a safe and effective therapeutic strategy, associated with high procedural success and encouraging short-term outcomes. A patient-specific approach, guided by meticulous preoperative imaging to determine the optimal access and the need for concomitant procedures, is key to minimizing complications. This hybrid technique offers a valuable alternative for patients who are not candidates for percutaneous intervention.

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Cite

BibTeXRIS
BibTeX
@article{dong2026multicenter,
  title = {{Multicenter experience of hybrid transcatheter pulmonary valve implantation in patients with a large right ventricular outflow tract}},
  author = {Jun Dong and Junwu Su and Aijun Liu and Shusheng Wen and Taibing Fan and Qi An and Bing Jia and Ming Ye and Gangcheng Zhang and Yongqiang Jin and Yaxiong Li and Cheng Zhou and Baoshi Zheng and Jing Xu},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1815136},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1815136/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Multicenter experience of hybrid transcatheter pulmonary valve implantation in patients with a large right ventricular outflow tract
AU  - Jun Dong
AU  - Junwu Su
AU  - Aijun Liu
AU  - Shusheng Wen
AU  - Taibing Fan
AU  - Qi An
AU  - Bing Jia
AU  - Ming Ye
AU  - Gangcheng Zhang
AU  - Yongqiang Jin
AU  - Yaxiong Li
AU  - Cheng Zhou
AU  - Baoshi Zheng
AU  - Jing Xu
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1815136
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1815136/full
AB  - Background: Management of pulmonary regurgitation (PR) in patients with a large and dysplastic native right ventricular outflow tract (RVOT) remains a significant challenge for percutaneous intervention. Given the limitations of percutaneous intervention in patients with a large and morphologically complex RVOT, this study aimed to evaluate the safety and efficacy of a hybrid transcatheter pulmonary valve implantation (TPVI) strategy using a self-expanding valve in this patient population.  Methods: Between June 2021 and December 2023, 102 patients with moderate-to-severe PR and dilated RVOT from 11 centers underwent hybrid TPVI with the Salus transcatheter pulmonary valve (TPV). Procedural strategies, including surgical access and concomitant procedures, were tailored based on comprehensive preoperative assessment.  Results: The mean age was 22.37 ± 11.15 years (range, 9–66), and 56.9% were male. The most common RVOT morphologies were pyramidal (37.2%) and tubular (30.4%). All procedures were successful. Twenty cases required cardiopulmonary bypass support. There were no intraoperative deaths. One in-hospital death occurred on postoperative day 12 in a high-risk patient with severe preoperative right ventricular dysfunction. All patients completed at least 1 year of follow-up, with a median follow-up duration of 1 year. During this period, significant improvements in right ventricular volumes (RVEDVI and RVESVI) and QRS duration were observed, whereas RVEF did not change significantly. There were no instances of coronary artery compression, valve embolization, or stent fracture. One suspected case of endocarditis was reported.  Conclusions: In patients with a large and morphologically complex RVOT, hybrid TPVI with the Salus TPV is a safe and effective therapeutic strategy, associated with high procedural success and encouraging short-term outcomes. A patient-specific approach, guided by meticulous preoperative imaging to determine the optimal access and the need for concomitant procedures, is key to minimizing complications. This hybrid technique offers a valuable alternative for patients who are not candidates for percutaneous intervention.
SN  - 2297-055X
ER  -