title: Percutaneous insertion of the pulmonary valve.
abstract: OBJECTIVE
  We report our experience of percutaneous valve insertion in pulmonary position in humans.
  
  
  BACKGROUND
  Over the past 40 years, prosthetic conduits have been developed to surgically establish continuity between the right ventricle and the pulmonary artery. However, stenosis and insufficiency of the conduit due to valvular degeneration or panus ingrowth frequently occur, limiting patients' lifespan. Percutaneous stenting of conduits has recently emerged as a technique for delaying surgical replacement, but it creates a pulmonary regurgitation when crossing the valve.
  
  
  METHODS
  Seven children and one adult with stenosis and/or insufficiency of the pulmonary graft underwent percutaneous implantation of a bovine jugular valve in pulmonary position.
  
  
  RESULTS
  Percutaneous pulmonary valve (PV) replacement was successful in all patients. No complications occurred in early follow-up. Angiography, hemodynamic studies and echocardiography after the procedure showed no significant regurgitation of the implanted valve. Implantation was effective in relieving the obstruction in five patients. All patients showed improvement in their clinical status at the latest follow-up (mean 10.1 months).
  
  
  CONCLUSIONS
  Non-surgical insertion of the PV is possible without any major complications. This new technique may have an important role in the management of conduit obstructions and pulmonary regurgitation.
authors.affiliation: Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom. Bonhop@gosh.nhs.uk
authors.forename: Philipp
authors.initials: P
authors.lastname: Bonhoeffer
authors.forename: Younes
authors.initials: Y
authors.lastname: Boudjemline
authors.forename: Shakeel A
authors.initials: SA
authors.lastname: Qureshi
authors.forename: Jerome
authors.initials: J
authors.lastname: Le Bidois
authors.forename: Laurence
authors.initials: L
authors.lastname: Iserin
authors.forename: Philippe
authors.initials: P
authors.lastname: Acar
authors.forename: Jacques
authors.initials: J
authors.lastname: Merckx
authors.forename: Jean
authors.initials: J
authors.lastname: Kachaner
authors.forename: Daniel
authors.initials: D
authors.lastname: Sidi
mesh_terms: D000293:Adolescent; D000328:Adult; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000295:instrumentation*; D002648:Child; D015150:Echocardiography, Doppler; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D011474:Prosthesis Design; D011665:Pulmonary Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000601:surgery