Transcatheter pulmonary valve implantation in clinical practice: A nationwide survey of cardiological implanting and non-implanting physicians.

Aim: Transcatheter Pulmonary Valve Implantation (TPVI), when feasible, is the first-line approach to pulmonary valve replacement. Our aim was to obtain a picture of current TPVI practice in Italy.
Methods: After conducting a literature review on TPVI, online surveys were devised by an Advisory Board of 10 experts from the three Italian reference centers for congenital heart diseases and sent electronically to physicians working either in implanting center or in referral non-implanting cardiologic centers.
Results: Approximately 450 physicians across Italy were invited to contribute. 82 (18%) physicians answered. EchoColorDoppler, electrocardiogram and cardiac magnetic resonance were considered the first line approach to monitor these patients, before and after TPVI.For non-implanting centers, reasons for non-referral of patients for PVR were: paucisymptomatic disease (67%) and patients' poor adherence to disease management programs (41%), but also the lack of connections with specialized centers (33%). For implanters, the main reasons for refraining from TPVI were: high risk for coronary compression (67% first rank), the need for concomitant cardiac surgical procedures (39% first rank) and the unsuitable anatomy of the conduit (39% first rank). The availability of new larger valves of a self-expandable nature was indicated as a key technological development for expanding the cohort of patients currently eligible for TPVI.
Conclusions: Despite a non-invasive imaging protocol for the follow up and selection of patients candidate to TPVI is well implemented in Italy, there is still a lack in connections between non-implanting and implanting centers.
Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Biagio Castaldi reports financial support and travel were provided by Medtronic. Gianfranco Butera reports financial support was provided by Medronic. Massimo Chessa reports financial support was provided by Medtronic. Lorenzo Galletti reports financial support was provided by Medtronic. Alessandro Giamberti reports financial support was provided by Medtronic. Luca Giugno reports financial support was provided by Medtronic. Aurelio Secinaro reports financial support was provided by Medtronic. Vladimiro Vida reports financial support was provided by Medtronic. Giovanni Di Salvo reports financial support was provided by Medtronic. Mario Carminati reports financial support was provided by Medtronic.
(© 2023 The Authors.)