[Percutaneous stented pulmonary valve implantation].
BACKGROUND
A number of congenital cardiac malformations involve the right ventricular outflow tract and are often treated with a biological valved conduit. The longevity of these valves is limited due to graft degeneration, which causes progressive valvular dysfunction and subsequently right ventricular failure. Due to the young age of these patients, repeat surgery can be expected and this has motivated the invention of the percutaneous stented valve implantation (PPVR).


METHODS
We retrospectively examined 13 patients (mean age 26 +/- 10 years) treated with PPVR between 2006 and 2008 at our institution. Indications for PPVR were conduit dysfunction with severe stenosis and/or regurgitation, reduced exercise capacity and right ventricular dilatation.


RESULTS
In all patients, immediate haemodynamic improvement occurred with full valvular competence after PPVR. The pressure gradient was reduced from 43 (+/- 15) mmHg to 12 (+/- 7) mmHg (p = 0,05) in patients with combined regurgitation and stenosis and 47 (+/- 14) mmHg to 12 (+/- 2) mmHg (p = 0,05) in patients with isolated stenosis. At mean follow-up after 141 (+/- 140) days, no reintervention had been required.


CONCLUSIONS
Significant haemodynamic and clinical improvement occurred after PPVR in all patients and no major complications occurred. PPVR remains a safe and minimally invasive treatment modality, and our study demonstrates that PPVR can be safely performed in a low volume setting.
Ersbøll
Mads
M
Kardiologisk Klinik B 2014, Rigshospitalet, DK-2100 København Ø, Denmark. mads.ersboell@gmail.com
Søndergaard
Lars
L
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000601:surgery; D011666:Pulmonary Valve Stenosis / Q000601:surgery; D012086:Reoperation; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult