A life-saving shift in congenital heart treatment

Minimally invasive procedures like TPVI are transforming congenital heart care, giving patients faster recovery and renewed hope. -123rf.com

FOR patients battling heart conditions, the evolution of treatments continues to offer hope, especially with the advent of innovative procedures like Transcatheter Pulmonary Valve Implantation (TPVI).

This minimally invasive procedure has transformed the way heart valve issues are managed, offering patients a chance at improved quality of life with faster recovery times.

National Heart Institute (IJN) Paediatric and Congenital Heart Centre (PCHC) consultant paediatric cardiologist and head Dr Marhisham Che Mood, shares insights into this groundbreaking procedure and how it’s helping patients with congenital heart disease and other heart conditions.

Pulmonary valve disease is a condition where the pulmonary valve, which regulates blood flow from the heart to the lungs, does not function properly.

This can result from congenital heart defects, infections, degenerative conditions or as a long term known complication of previous congenital heart surgeries.

Studies indicate that congenital heart disease, which often necessitates pulmonary valve intervention, affects approximately one in 100 newborns globally.

Patients with pulmonary valve disease often experience symptoms such as shortness of breath, fatigue, swelling in the legs or abdomen, and irregular heartbeats.

If left untreated, the condition can lead to severe complications in severe cases, including heart failure, arrhythmias, and reduced oxygen levels in the body.

“TPVI is a life-changing procedure that allows us to replace a defective pulmonary valve without open-heart surgery.

“The procedure uses state-of-the-art valves such as the Melody valve, Venus P valve, and Edward Sapien valve. The choice of valve depends on the patient’s specific needs and suitability,” says Dr Marhisham.

The TPVI procedure involves threading a catheter through the femoral vein to the heart, where the new valve is implanted without the need for a surgical incision.

This offers significant advantages, including shorter hospital stays, quicker recovery times, and less post-operative discomfort compared to traditional open-heart surgery.

Unlike conventional valve replacement surgery, which requires stopping the heart and using a heart-lung machine, TPVI is performed while the heart continues to beat, significantly reducing surgical risks.

Pulmonary valve disease, if untreated, can severely impact heart function and overall well-being.

Patients at risk include those born with congenital defects such as Tetralogy of Fallot— a condition requiring pulmonary valve repair or replacement later in life.

Reports suggest that approximately 50% of individuals who undergo childhood heart surgery for congenital defects will require reintervention in adulthood.

By offering a minimally invasive solution, TPVI has become a preferred option for many, reducing hospital stays from several weeks to just a few days and allowing most patients to return to normal activities within weeks.

The Melody valve, Venus P valve, and Edward Sapien valve are each designed to cater to different patient conditions and anatomies, providing a customised solution for those in need.

Dr Marhisham emphasises that each patient’s suitability is carefully evaluated to ensure the best possible outcome.

A range of factors, including the patient’s age, anatomy and the specific condition of their pulmonary valve, are considered before the most appropriate valve option is recommended.

As part of its broader commitment to heart health, IJN also marked World Heart Day 2025 with a five-day celebration from Sept 24 to 28 at The Curve, combining fun, fitness and awareness to encourage healthier living.