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Percutaneous pulmonic valve implantation

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Opinion statement

Surgically placed valve conduits between the right ventricle and pulmonary artery often fail within 10 years. The failure may be the result of insufficiency, stenosis, or often a combination of the two. Pulmonic valve insufficiency may lead to right ventricular dilatation, heart failure, arrhythmias, and death. Reoperation requires cardiopulmonary bypass, which may aggravate an already failing right ventricle, and is associated with a higher risk of death and significant morbidity. Therefore, percutaneous implantation of a pulmonic valve is an attractive option to improve hemodynamic function and ameliorate symptoms. Initial experience with various types of percutaneous pulmonary valve systems demonstrates the procedure to be effective and safe. Improvements in technique and device modification are evolving rapidly. Studies and clinical follow-up are ongoing to further assess functional improvement, freedom from adverse cardiac events, and longevity of percutaneously implanted valves.

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References and Recommended Reading

  1. Bove EL, Byrum CJ, Thomas FD, et al.: The influence of pulmonary insufficiency on ventricular function following repair of tetralogy of Fallot. Evaluation using radionuclide vetriculography. J Thorac Cardiovasc Surg 1983, 85:691–696.

    CAS  PubMed  Google Scholar 

  2. Abd El Rahman MY, Abdul-Khaliq H, Vogel M, et al.: Relation between right ventricular enlargement, QRS duration, and right ventricular function in patients with tetralogy of Fallot and pulmonary regurgitation after surgical repair. Heart 2000, 84:416–420.

    Article  CAS  PubMed  Google Scholar 

  3. De Ruijter FT, Weenink I, Hitchcock FJ, et al.: Right ventricular dysfunction and pulmonary valve replacement after correction of tetralogy of Fallot. Ann Thorac Surg 2002, 73:1794–1800.

    Article  PubMed  Google Scholar 

  4. Therrien J, Siu SC, McLaughlin PR, et al.: Pulmonary valve replacement in adults late after repair of tetralogy of Fallot: are we operating too late? J Am Coll Cardiol 2000, 36:1670–1675.

    Article  CAS  PubMed  Google Scholar 

  5. Therrien J, Siu SC, Harris L, et al.: Impact of pulmonary valve replacement on arrhythmia propensity late after repair of tetralogy of Fallot. Circulation 2001, 103:2489–2494.

    CAS  PubMed  Google Scholar 

  6. Tweddell JS, Pelech AN, Frommelt PC, et al.: Factors affecting longevity of homograft valves used in RVOT reconstruction for CHD. Circulation 2000, 102(Suppl 3):III130–III135.

    CAS  PubMed  Google Scholar 

  7. Homann M, Haehnel JC, Mendler N, et al.: Reconstruction of the RVOT with valved biological conduits: 25 years experience with allografts and xenografts. Eur J Cardiothorac Surg 2000, 17:624–630.

    Article  CAS  PubMed  Google Scholar 

  8. Therrien J, Provost Y, Merchant N, et al.: Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. Am J Cardiol 2005, 95:779–782.

    Article  PubMed  Google Scholar 

  9. Bonhoeffer P, Boudjemline Y, Saliba Z, et al.: Transcatheter implantation of a bovine valve in pulmonary position. A lamb study. Circulation 2000, 102:813–816.

    CAS  PubMed  Google Scholar 

  10. Bonhoeffer P, Boudjemline Y, Saliba Z, et al.: Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet 2000, 356:1403–1405.

    Article  CAS  PubMed  Google Scholar 

  11. Khambadkone S, Coats L, Taylor A, et al.: Percutaneous pulmonary implantation in humans: results in 59 consecutive patients. Circulation 2005, 112:1189–1197.

    Article  PubMed  Google Scholar 

  12. Garay F, Webb J, Hijazi ZM: Percutaneous replacement of pulmonary valve using the Edwards-Cribier percutaneous heart valve: first report in a human patient. Catheter Cardiovasc Interv 2006, 67:659–662.

    Article  PubMed  Google Scholar 

  13. Kostolny M, Tsang V, Nordmeyer J, et al.: Rescue surgery following percutaneous pulmonary valve implantation. Eur J Cardiothorac Surg 2008, 33:607–612.

    Article  PubMed  Google Scholar 

  14. Hamzeh RK, El-Said HG, Moore JW: Left main coronary artery compression from right pulmonary artery stenting. Catheter Cardiovasc Interv 2009, 73:197–202.

    Article  PubMed  Google Scholar 

  15. Nordmeyer J, Khambadkone S, Coats L, et al.: Risk stratification, systemic classification, and anticipatory management strategies for stent fracture after percutaneous pulmonary valve implantation. Circulation 2007, 115:1392–1397.

    Article  PubMed  Google Scholar 

  16. Lurz P, Coats L, Khambadkone S, et al.: Percutaneous pulmonary valve implantation: impact of evolving technology and learning curve on clinical outcome. Circulation 2008, 117:1964–1972.

    Article  PubMed  Google Scholar 

  17. Cribier A, Eltchaninoff H, Bash A, et al.: Percutaneous transcatheter implantation of an aortic valve prosthesis for calcified aortic stenosis: first human case description. Circulation 2002, 106:3006–3008.

    Article  PubMed  Google Scholar 

  18. Eltchaninoff H, Tron C, Cribier A: Percutaneous implantation of aortic valve prosthesis in patients with calcified aortic stenosis: technical aspects. J Interv Cardiol 2003, 16:515–521.

    Article  PubMed  Google Scholar 

  19. Ródes-Cabau J, Houde C, Perron J, et al.: Delayed improvement in valve hemodynamic performance after percutaneous pulmonary valve implantation. Ann Thorac Surg 2008, 85:1787–1788.

    Article  PubMed  Google Scholar 

  20. Al Qethamy H, Momenah T, El Oakley R, et al.: Minimally invasive transventricular implantation of pulmonary xenograft. J Card Surg 2008, 23:339–340.

    Article  PubMed  Google Scholar 

  21. Schreiber C, Hörer J, Vogt M, et al.: A new treatment option for pulmonary valvar insufficiency: first experiences with implantation of a self-expanding stented valve without use of cardiopulmonary bypass. Eur J Cardiothorac Surg 2007, 31:25–30.

    Article  Google Scholar 

  22. Dore A, Glancy DL, Stone S, et al.: Cardiac surgery for grown-up congenital heart patients: survey of 207 consecutive operations from 1991 to 1994. Am J Cardiol 1997, 80:906–913.

    Article  CAS  PubMed  Google Scholar 

  23. Somerville J: Grown up congenital heart disease—medical demands look back, forward 2000. Thorac Cardiovasc Surg 2001, 49:21–26.

    Article  CAS  PubMed  Google Scholar 

  24. Ghez O, Tsang VT, Frigiola A, et al.: Right ventricular outflow tract reconstruction for pulmonary regurgitation after repair of tetralogy of Fallot; preliminary results. Eur J Cardiothorac Surg 2007, 31:654–658.

    Article  PubMed  Google Scholar 

  25. Dave HH, Buechel ER, Dodge-Khatami, et al.: Early insertion of a pulmonary valve for chronic regurgitation helps restoration of ventricular dimensions. Ann Thorac Surg 2005, 80:1615–1620.

    Article  PubMed  Google Scholar 

  26. Gengsakul A, Harris L, Bradley TJ: The impact of pulmonary valve replacement after tetralogy of Fallot repair: a matched comparison. Eur J Cardiothorac Surg 2007, 32:462–468.

    Article  PubMed  Google Scholar 

  27. Coats L, Khambadkone S, Derrick G, et al.: Physiological and clinical consequences of relief of right ventricular outflow tract obstruction late after repair of congenital heart defects. Circulation 2006, 2037–2044.

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Correspondence to Ziyad M. Hijazi.

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Kumar, A., Kavinsky, C., Amin, Z. et al. Percutaneous pulmonic valve implantation. Curr Treat Options Cardio Med 11, 483–491 (2009). https://doi.org/10.1007/s11936-009-0051-3

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