Transcatheter pulmonary valve replacement: valves, techniques of implantation and outcomes

Transcatheter pulmonary valve replacement has changed the way we approach congenital and structural heart disease. In patients with a conduit between the right ventricle and pulmonary artery or a bioprosthetic pulmonary valve, there will eventually be pulmonary valve dysfunction. This leads to right ventricular failure and possibly arrhythmias. Due to prior operations and the comorbid conditions that these patients have, reoperation to replace the pulmonary valve is complicated and associated with greater morbidity and mortality than the initial operation. The percutaneous insertion of a stented bioprosthetic valve offers a less invasive option. The valve is inserted into the dysfunctional conduit/bioprosthetic valve via the femoral vein or internal jugular vein. Most patients are able to return home the following day without the prolonged recovery period that follows conventional open heart surgery. Both shortand long-term outcomes appear to be promising with freedom from reintervention over 90% at 1 year and a major complication rate of less than 3%.