Percutaneous pulmonary valve implantation as an alternative to repeat open-heart surgery for patients with pulmonary outflow obstruction: a reality in Singapore.

Right ventricle to pulmonary artery (RV-PA) conduits have been used for the surgical repair of congenital heart defects. These conduits frequently become stenosed or develop insufficiency with time, necessitating reoperations. Percutanous pulmonary valve implantation (PPVI) can delay the need for repeated surgeries in patients with congenital heart defects and degenerated RV-PA conduits. We present our first experience with PPVI, and describe in detail the procedural methods and the considerations that need to be taken for this intervention to be successful. The immediate and short-term clinical outcomes of our patients are reported - good haemodynamic results were obtained, both angiographically and on echocardiography. PPVI provides an excellent alternative to repeat open-heart surgery for patients with congenital heart defects and degenerated RV-PA conduits. This represents a paradigm shift in the management of congenital heart disease, which is traditionally managed by open-heart surgery.