Abstract: Pulmonic valve disease is ubiquitous across age, gender and ethnicity. The pulmonary valve is unique in that the incidence of congenital cases far outnumbers the incidence of acquired cases.
The most prevalent pulmonary valve disease is pulmonary stenosis (PS), either isolated or in concert with other congenital heart disease. The treatment for PS has a storied history dating back to 1913 with the first ever intracardiac surgery. Over the past century interventions on the pulmonary valve have undergone a remarkable evolution progressing from closed, ―blind‖ surgical valvotomy to open surgical valvotomy and finally percutaneous balloon valvuloplasty, all with excellent procedural and long term outcomes.
A frequent consequence of pulmonary valve intervention is pulmonary valve regurgitation. Although once thought to be a benign entity, pulmonary insufficiency and chronic ventricular volume overload will cause the right ventricle to fail given enough time. A burgeoning population of patients who underwent surgical repair of congenital heart disease now require additional interventions as adults, primarily on their right ventricular outflow tract.
Percutaneous bioprosthetic pulmonary valves offer a new minimally invasive strategy of managing this complex patient population. This chapter will review the history of pulmonic valve interventions and discuss current technology in percutaneous pulmonary valve treatments.