Novel less invasive approach to paediatric pulmonary valve replacement at Skåne University Hospital

Three children have received new pulmonary artery valves using a faster and gentler method, says Petru Liuba, senior physician and professor.
In February 2025, three children at Skåne University Hospital received a new type of pulmonary valve through a method that is both faster and less invasive. The procedure is performed using a catheter inserted into the body through large veins and guided to the heart. Previously, open-heart surgery was the only available option in children with large-sized leaking pulmonary valves due to congenital heart defects.

Although several types of transcatheter pulmonary valves are now available for valve replacement, the new valve offers certain advantages, including a shorter procedure time and excellent clinical outcomes.

Faster procedure

Catheter-based procedures are now common in paediatric cardiology. However, until recently, open-heart surgery was the only option for replacing leaking valves in children with large, native pulmonary arteries who had previously undergone heart surgery.

Traditional open-heart surgery for pulmonary valve replacement takes up to three to four hours and requires up to a week of hospitalisation. With the new valve, pulmonary valves can be replaced in approximately one hour and the patient can be discharged within two days after the intervention. 

Positive results

“The results so far are promising: the procedures have been highly successful, are quick and allow for faster patient recovery. In most cases, children can be discharged from hospital the following day,” says Petru Liuba, who leads the cardiac catheterization team at the Children's Heart Centre at Skåne University Hospital and serves as professor at Lund University.

Here is the team behind the successful procedures.

The method utilises a new type of self-expanding valve (“Harmony”) developed by Medtronic, which received CE marking in January, approving it for use in Europe.

The Paediatric Heart Centre at Skåne University Hospital is the first in the Nordic region and the third in Europe to use this valve as part of a European clinical post-market study. Earlier this year, the procedure was performed at two hospitals in Germany. In total, ten hospitals across Europe are participating in the “Medtronic Harmony European Post-Market Study.”

The surgical team practiced several times before performing the first operation.

Faster recovery

This method is suitable for children from the age of 9 to 10 years who have previously undergone heart surgery and present with enlarged right ventricle and fatigue due to leaking pulmonary valve. Each year, 25–30 older children in Sweden require pulmonary valve replacement, with approximately half of these procedures being performed at Skåne University Hospital.

“The excellent results reported by previous studies performed outside Europe and our early experience with this valve mean that we will now continue using this method for a significant proportion of patients who previously required conventional surgery for pulmonary valve replacement,” says Petru Liuba.

For medical reasons, the procedure is not suitable for all patients.
“We estimate that up to two-thirds of all children with this condition could be treated using the new method. Computer tomography scans are used to determine which children are eligible,” explains Petru Liuba. 

Last updated: 2025-04-01