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Transcatheter Pulmonary Valve Replacement

Pulmonary valve replacement is a procedure that replaces a diseased pulmonary valve.

The pulmonary valve is one of four valves that regulate blood flow in the heart. The valve lies between the lower right heart chamber (right ventricle) and the pulmonary artery.

Pulmonary valve disease is a condition in which the pulmonary valve doesn't work properly. The condition can disrupt blood flow from your heart to your lungs. This may occur on its own or in connection with a congenital heart defect, such as tetralogy of Fallot. Often, the condition may only be detected by a physical evaluation or heart imaging.

Pulmonary valve replacement can restore normal blood flow, reduce symptoms, improve your heart's condition, and prolong life.

Why choose Presbyterian for your transcatheter pulmonary valve replacement?

Presbyterian Heart and Vascular Care has a skilled interventional cardiology team who can provide a wide range of interventional and structural heart treatments. Their interventional cardiologists are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and the opportunity to recover at home.

Who is eligible for a transcatheter pulmonary valve replacement?

Getting a pulmonary valve replacement depends on many factors, including:

  • Your age and overall health.

  • The severity of your pulmonary valve disease.

  • Whether you need to correct another heart problem. Both conditions can be treated at once, making surgery more worth the risk.

What conditions can be treated with a transcatheter pulmonary valve replacement?

Types of pulmonary valve disease that may require a pulmonary valve replacement include:

  • Pulmonary valve regurgitation: A leaky pulmonary valve allows blood to flow backward into the heart rather than directly to the lungs for oxygen.

  • Pulmonary valve stenosis: The pulmonary valve is thickened or obstructed, making it harder for it to open properly.

  • Pulmonary atresia: This is a congenital heart defect in which a child is born without a well-defined pulmonary valve. Blood can't flow from the right ventricle into the pulmonary artery. The only blood flow to the lungs is through an open passageway between the pulmonary artery and the main artery supplying blood to the body (aorta).

How do I prepare for a transcatheter pulmonary valve replacement?

You will need to decide what kind of valve you want: mechanical or biological (human, pig or cow). Doctors will discuss with you the risks and benefits of each type of valve and discuss which valve may be appropriate for you. If you have a mechanical valve, you'll need to take blood-thinning medications for the rest of your life to prevent blood clots. If you have a biological valve, it may need to be replaced eventually as they degenerate over time.

Before being admitted to the hospital for your surgery, talk to your caregivers about your hospital stay and discuss any help you may need when you return home.

Talk to your doctor about:

  • When you can take your regular medications and whether you can take them before your surgery.

  • When you should stop eating or drinking the night before the surgery.

Bring these items:

  • A list of your medications.

  • Your eyeglasses, hearing aids, or dentures.

  • Loose-fitting, comfortable clothing.

  • A copy of your advance directive or living will.

  • Items that may help you relax, such as portable music players or books.

  • Personal care items, such as a brush, comb, shaving equipment, and toothbrush.

What should I expect during my transcatheter pulmonary valve replacement?

For most pulmonary valve replacement procedures, you'll receive medications that put you to sleep so you won't feel pain.

Your doctor inserts a catheter in a large blood vessel in the groin or chest and guides it to the heart. A balloon-expandable replacement pulmonary valve that sits at the end of the catheter is into place. The catheter may insert a new pulmonary valve within the existing diseased valve.

During the procedure and your hospital stay, your treatment team will:

  • Watch for signs of infection in your incision sites.

  • Work with you to manage any pain you have after surgery.

  • Periodically check your blood pressure, breathing, and heart rate.

  • Instruct you to walk regularly to gradually increase your activity and do breathing exercises as you recover.

How do I care for myself after my transcatheter pulmonary valve replacements?

After pulmonary valve replacement surgery, you will eventually be able to return to daily activities, such as working, driving, and exercise.

You'll need to take certain medications and attend regular follow-up appointments with your doctor. You may have several tests to evaluate and monitor your condition.

Your doctor may instruct you to make some healthy lifestyle changes. Your doctor may also recommend that you participate in cardiac rehabilitation—a program of education and exercise designed to help you improve your health and help you recover after heart surgery.

Lifestyle changes you can make to improve your heart health include:

  • Reduce salt in your diet.
  • Maintain a healthy body weight.
  • Never smoke, or stop smoking.
  • Drink only moderate amounts of alcohol, if any. This means an average of one to two drinks per day for men and one drink per day for women.
  • Eat a healthy, well-balanced diet, rich in fresh fruit and vegetables but low in saturated fats, processed sugar, and salt.
  • If you have diabetes, work closely with your doctor to make sure it is controlled.
  • Get at least 150 minutes of moderate to intense physical exercise every week.