Percutaneous pulmonic valve implantation.

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.