Percutaneous pulmonary valve implantation: the Munich experience

摘要

Percutaneous pulmonary valve implantation is one of the most significant advances in catheter interventionai treatment of patients with congenital heart disease within the last 10 years. The lifetime of biological conduits in the right ventricular outflow tract can be expanded and, hence, patients may have fewer open heart surgeries during their lifetime. Careful patient selection is mandatory. The correct timing of percutaneous pulmonary valve implantation, especially in the presence of prevailing pulmonary regurgitation, is still a matter of debate. Prestenting ensures a good hemodynamic result, lowers the incidence of stent fractures and enables the treatment of patients with a 'native' right ventricular outflow tract. Coronary arterial compression and conduit rupture are the major peri procedural hazards. The only fatalities occurred after coronary arterial compression. Further studies are needed to demonstrate the excellent short time results are sustained over time. The intervention should only be carried out by an experienced interventionalist.