Percutaneous pulmonary valve replacement.

Percutaneous pulmonary valve implantation helps in prolonging the lifespan of surgically placed right ventricle-to-pulmonary artery (RV-PA) conduits, and represents a less invasive alternative to repeat open-heart surgery. The clinical indications for treatment match those of surgery. As far as the suitability is concerned, the current ideal substrate is a degenerated RV-PA conduit, because of the presence of a certain degree of calcification that offers a safe anchoring point. So far, patients have been treated with low morbidity and mortality that were further improved with increasing experience. After percutaneous pulmonary valve implantation, patients experience a subjective improvement, mirrored by an objective increase of measured exercise capacity parameters and by reduced RV-PA gradient, regurgitant fraction, and RV volumes. New developments in the experimental field should result in an extension of indications in the future.