Pediatric transcatheter pulmonary valve implantation
Transcatheter pulmonary valve implantation is a procedure to treat a heart defect that a child has had since birth, like pulmonary stenosis. This is a minimally invasive treatment, which means children can recover and get back to their regular activities much faster than with traditional open heart surgery.
At Children’s Health℠, our doctors are national experts in this procedure and use the latest technology to help your child have the best outcomes.
What is a pediatric transcatheter pulmonary valve implantation?
When a child is born with an abnormality in the part of their heart called the pulmonary valve, they often need a valve implanted so their heart can work properly. Some children have an artificial valve or surgical patch placed in their heart when they are babies. As they grow, they need a pulmonary valve implanted to continue to treat their condition.
In a transcatheter pulmonary valve implantation procedure, the doctor uses a thin tube (catheter) to implant a valve and tissue into the child’s heart. The catheter is inserted through the child’s leg and doctors use a state-of-the-art system to precisely place the valve and tissue.
This treatment is not surgery. It is a minimally invasive alternative to open heart surgery.
What are the benefits of a pediatric transcatheter pulmonary valve implantation?
Minimally invasive - This procedure carries far less risk than open heart surgery. In this transcatheter procedure, doctors access the heart using a small cut in the leg instead of opening the chest and using a heart and lung machine.
Quick recovery - Typically, after the procedure, children only spend about 24 hours in the hospital and don’t go to the cardiac intensive care unit (CICU). After leaving the hospital, most children can resume their regular activities within one week. After open heart surgery, children typically spend five to seven days in the CICU, and the recovery period is much longer.
Eligibility for future transcatheter procedures - Children who need pulmonary valve implantation typically need replacement surgery within five to 15 years. Once they undergo a transcatheter procedure, they are more likely to be able to undergo this minimally invasive procedure in the future too.
What are the side effects of a pediatric transcatheter pulmonary valve implantation?
Sometimes children will have a bruise on their leg where the catheter was inserted. Typically, the bruise is mild and will go away in about a week, just like any bruise.
What are the risks of a pediatric transcatheter pulmonary valve implantation?
This procedure has much lower risks than open heart surgery, but there are still some risks. Worldwide, about 7% of children with an implanted pulmonary valve get a bacterial infection. To minimize this risk, your child will receive antibiotics while they’re at the hospital recovering from the procedure. The doctor will also provide instructions to continue to minimize this risk, like taking aspirin daily, which reduces the risk of blood clotting and infection on the valve.
There’s also a very low risk of the following:
Abnormal heart rhythms - Abnormal heart rhythms can occur after a valve is implanted. This occurs in less than 1% of patients, and it's not typically long-lasting.
Open heart surgery - Before the procedure, doctors perform extensive tests to plan this transcatheter procedure. But, in a very small number of children, doctors may find that they need to do open heart surgery to complete the procedure successfully. That is rare, but doctors are always prepared with another approach if necessary.
What are Children’s Health’s outcome metrics for a pediatric transcatheter pulmonary valve implantation?
The success rate of this procedure is 99%. That means the vast majority of children have a successful implant that lasts at least five years. Most patients have implanted valves that last 10 to 15 years.
At Children’s Health, we perform more transcatheter pulmonary valve implantation procedures than any center in our region. This means we have the experience to understand your child’s risks and keep them to an absolute minimum.
What to expect with a pediatric transcatheter pulmonary valve implantation
We tailor this minimally invasive procedure to meet each child’s needs.
What to expect before a pediatric transcatheter pulmonary valve implantation
At least one week before the procedure, doctors will do several tests so they can tailor the treatment for your child’s specific condition. These tests might include a CT scan, MRI scan or a chest X-ray to get images of your child’s heart. Doctors will also perform an echocardiogram and EKG to get information about the structure and function of your child’s heart.
Our team of renowned physicians, including cardiologists, cardiac surgeons and anesthesiologists, will meet to review these tests and plan your child’s procedure.
On the day of the procedure, your child shouldn’t have anything to eat for about six hours before the procedure. At two hours before the procedure, they should stop drinking liquids. If your child is currently taking medication, your cardiologist will provide instructions on taking those medicines before the procedure.
What to expect during a pediatric transcatheter pulmonary valve implantation
When you and your child arrive at the hospital, doctors will prepare your child for the procedure. We have child lfe specialists available who can help children who may be nervous or scared to feel as comfortable as possible before the procedure.
The procedure typically takes about two hours. Then, we’ll bring your child to the cardiac ward for recovery and observation for about 24 hours. Parents can meet their child in recovery and spend the night with them.
Before leaving the hospital, doctors will do a chest X-ray and echocardiogram to evaluate your child’s heart. Your cardiologist will also provide instructions on your child’s medication and caring for their leg, which will have a bandage over the small area where the catheter was inserted.
What to expect after a pediatric transcatheter pulmonary valve implantation
Rest - For one week after the procedure, doctors recommend children rest and refrain from activities like contact sports and bike riding. After that, children can return to all of their regular activities.
Follow-up care - Then, children will see their cardiologist one month, six months and one year after this procedure to make sure their heart is working properly. Typically, the valves last for at least five years with some lasting up to 15 years, but the valve will eventually need to be replaced. Your child will continue to see their cardiologist once a year after their procedure so they can continue to provide the best treatment plan.
Adult congenital heart disease - At Children’s Health, we have several pediatric cardiologists who are also board-certified in adult congenital heart disease, so we can continue to provide follow-up care for your child as they grow into adulthood.