Percutaneous pulmonary valve implant: two Colombian case reports

Abstract

Patients with congenital heart disease that involves reconstruction of the right ventricular (RV) outflow tract must frequently undergo interventions derived from the limited useful life of the surgical canals, which leads to the development of RV dysfunction due to changes in the ventricular geometry and predisposition to lethal arrhythmias, with the consequent risk of reinterventions. The percutaneous pulmonary valvular implant is a new therapeutic alternative, less invasive, compared to surgery, for selected patients. A review of the available literature is made, and the initial experience of percutaneous pulmonary valve implantation in a Colombian center of high complexity for the treatment of cardiovascular diseases is described, in two patients with aortic homograft dysfunction in a pulmonary position with double valvular lesion, in which the percutaneous pulmonary valve implant was a successful strategy. Patients with congenital heart disease were chosen, with dysfunctional surgical conduits with stenosis or significant pulmonary insufficiency, with dysfunction and RV dilatation. The standard technique for the implantation of the Melody pulmonary valve was used without complications during the procedure or 1 year of follow-up. Percutaneous implantation of the pulmonary valve is a great advance in the management of patients with congenital heart diseases, with favorable results in the short and medium-term, allowing the restoration of ventricular function with minimal risk, compared to surgical replacement in selected patients.