Transcatheter Valve Implantation
Interventional Cardiology
Over the past 20 years, interventional cardiologists have developed heart valves that can be implanted via a catheter from a peripheral vein. While previous approaches to replace heart valves have traditionally meant open-heart surgery, these transcatheter valves can be placed without surgery and patients usually go home the next day.
Right-sided heart lesions
Pulmonary valve regurgitation is one of the major problems in repaired congenital heart disease patients. Since many congenital heart defects involve the right ventricle and pulmonary valve, repairing some defects can often lead to a regurgitant, or leaky, valve that can cause the right heart to dilate over the ensuing years.
Adult congenital heart disease patients
One of the fastest growing populations in cardiology are patients with adult congenital heart disease (ACHD). Since over 90% of children now born with heart problems now reach adulthood, these ACHD patients are growing at a rate of over 5% per year and we now have over 1.3 million ACHD patients in the U.S. However, all of these patients need ongoing care and many of them still need interventions and cardiac operations. One of the most common problems is pulmonary valve regurgitation, which often means an ACHD patient needs a new pulmonary valve.
Transcatheter valves for all ages
For older patients with enlarged right-ventricular outflow tracts (RVOTs), the early transcatheter valves were not large enough. So, the Harmony™ valve was designed to fit into very dilated RVOTs, as large as 4.3cm. Importantly, the U.S. FDA (Food and Drug Administration) approved the Harmony valve for use in March 2021, the first transcatheter valve to achieve such distinction. All across the cardiology community, this transcatheter valve is thought to be a “game-changer” because we can now offer transcatheter valves to the majority of patients with pulmonary valve problems.
Phoenix Children's first in Arizona to implant Harmony™ valve
In September 2021, our interventional cardiology team implanted the first two Harmony valves in the state of Arizona (read more about this in our blog). We were chosen because of our expertise in ACHD and in congenital cardiac catheterization. Two patients were found to have severely regurgitant pulmonary valves that were leading to a very enlarged right ventricle and symptoms of fatigue and decreased exercise tolerance.
Harmony™ transcatheter valve
Harmony™ transcatheter valve delivery system
After a multidisciplinary review of these patients, along with special computed tomographic (CT) imaging, our Heart Center team found that they were excellent candidates for this new Harmony valve, which was successfully implanted in each. These two patients avoided another open-heart procedure and went home the day after the valve was placed. Both patients continue to do very well at follow up.
Before valve implantation
Post valve implantation
Phoenix Children’s Heart Center – committed to care
These cases highlight our commitment to high-quality care at Phoenix Children’s Heart Center. And now, with our subspecialty Fetal Care Center and accredited ACHD Program, in addition to our new Women’s and Children’s Pavilion opening soon in the East Valley, we now offer care from fetal life to adulthood. With our Heart Center Co-Directors, Dr. Wayne J. Franklin and Dr. Daniel A. Velez, we are committed to provide comprehensive, patient-centered care for families in Arizona and beyond.
Phoenix Children’s Heart Center Co-Directors, Dr. Wayne Franklin and Dr. Daniel Velez talk about the new Harmony transcatheter heart valve that Phoenix Children’s were recently the first to implant in Arizona.