A Release Valve

Nonsurgical options for patients with pulmonary valve conditions

Patients with congenital heart disease often undergo several surgeries over the course of their lives to implant and/or replace a conduit or heart valve. Yet transcatheter pulmonary valve replacement (TPVR) is minimally invasive, safe and has been shown to be a viable, longer-lasting alternative to open surgery—and possibly even multiple procedures.

After TPVR, most patients are able to resume their normal daily activities within the week. This is quite a difference from the four to six weeks of aftercare and activity restrictions generally required to recover from open heart surgery. This minimally invasive procedure can be performed on both adult and pediatric patients, and contraindications are rare.

Since December 2017, John F. Rhodes, M.D., a pediatric and adult congenital interventional cardiologist, has been performing TPVR—along with other interventional cardiology measures—to revise right ventricular outflow tracts. Rhodes has recently returned to MUSC as the operations director for the MUSC Children’s Health Congenital Heart Center and as an interventional specialist for children and adults with congenital heart disease.

Follow-up data for patients who have had TPVR compare favorably with those patients who have undergone surgical valve replacement. Rhodes believes this beneficial outcome is due to a reduction in the body’s inflammatory response with transcatheter procedures versus open surgery.

He also feels encouraged that the data suggest TPVR will further improve outcomes. “Surgical valve replacement [in patients who have had prior valve replacement surgeries] has been shown to last about seven to ten years at most,” says Rhodes. “We’re hoping TPVR will be more like ten to twenty years.” Rhodes would like to see TPVR used for patients who have not had previous surgeries; he believes patient responses will be even better for that subset.

“This is profound for the patient,” adds Rhodes. “When you do an operation and fix the pulmonary valve, it usually doesn’t last a lifetime. Many patients have about two or three operations before they even turn 18. But what if we could prevent major surgeries, and the patient could improve both physical and psychological recovery? This is revolutionizing medicine. It’s amazing technology, and I can’t wait to see where we go next.”