Transcatheter Pulmonary Valve Replacement (TPVR)

When a child’s pulmonary valve is not working properly, blood cannot flow efficiently from the heart to the lungs and the valve may need to be replaced. Transcatheter Pulmonary Valve Replacement (TPVR) offers a less invasive, non-surgical option to replace the pulmonary valve and can lengthen the time between necessary operations or avoid the need for surgical valve replacement all together. All TPVR procedures are performed in our state-of-the-art hybrid cardiac catheterization laboratory.

How Does It Work?

A catheter, which holds the replacement valve, is inserted into the blood vessel, usually through the leg.  A continuous x-ray image is used to guide the catheter to the location of the leaky valve in the heart. Once the new valve is positioned properly it expands to fit into place and immediately begins directing blood flow. Our team of pediatric interventional cardiologists are experts in transcatheter pulmonary valve replacement using multiple types of valves.


Dr. Jeremy Ringewald, pediatric cardiologist and director of the pediatric cardiac catheterization lab at the Patel Children’s Heart Institute was the first physician in Tampa Bay (and one of the first in Florida) to implant the Melody transcatheter pulmonary valve. Four years later, he implanted the hospital’s first SAPIEN transcatheter pulmonary valve, offering another less invasive option to surgery. Since the program’s initiation, hundreds of children at St. Joseph’s Children’s Hospital have benefited from this paradigm-shifting new technology, placing us at the forefront of pediatric cardiac care.

St. Joseph’s Children’s Hospital continues to be a lead the way for these valve procedures both locally and state-wide, by offering the most cutting-edge devices available, including the new Harmony valve and Alterra Adaptive pre-stent. “While the ability to replace pulmonary valves in the catheterization laboratory has been an option for many years, previously available transcatheter valve systems only allowed us to treat a small subset of patients. The Harmony and Alterra are game changers and allows us to expand minimally invasive options for far more patients with pulmonary valve disease", says Dr. Ringewald.

Benefits of Transcatheter Pulmonary Valve Replacement

Minimally invasive-This procedure carries less risk than open heart surgery. It’s performed via small incisions in the upper thigh instead of opening the chest.

Quick recovery
-Typically, the procedure lasts three to four hours and patients are discharged in less than 24 hours afterwards, without staying in the ICU. They can generally return to school or work in less than a week and have no activity restrictions within a few weeks. After open heart surgery, children typically spend five to seven days in the ICU, and the recovery period is much longer.