Percutaneous implantation of pulmonary valves for treatment of right ventricular outflow tract dysfunction: a single-centre experience

Stenosis and/or regurgitation of the right-ventricle-to-pulmonary-artery conduit are common conditions in patients after corrective surgery for congenital heart defects. Percutaneous pulmonary valve implantation was introduced to reduce the number of operations needed during the total lifetime of patients with right-ventricle-to-pulmonary-artery conduits. Between April 2007 and April 2008, six patients with severe stenosis and/or regurgitation of the conduit underwent percutaneous pulmonary valve implantation. Cardiac diagnoses were tetralogy of Fallot (three patients), truncus arteriosus (two patients) and post Ross operation (one patient). The median age was 13 (range 7-21) years. Deployment of percutaneous pulmonary valve implantation was achieved without major complications. Right ventricular systolic pressure and right ventricular outflow tract gradient decreased respectively from 61 to 40 mmHg and 37 to 20 mmHg. Follow-up ranged from-to 16 (mean 11) months. All patients are free from reoperation, and valvular competence has been well maintained. One patient experienced recurrence of the obstruction, which was successfully treated with transcatheter balloon dilatation 9 months after the implant. This small study confirms Professor Bonhoeffer's findings that percutaneous pulmonary valve implantation is a safe and feasible treatment that allows the avoidance of surgery in postoperative congenital heart disease patients with a dysfunctioning right-ventricle-to-pulmonary-artery conduits.