Transcatheter Pulmonary Valve Replacement in Secondary Cardiac Surgery Patient: Anatomical and Technical Challenges.

BACKGROUND

Pulmonary regurgitation (PR) plays a vital role in the patient with post-surgical reconstruction of the right ventricular outflow tract (RVOT) or in tetralogy of Fallot.

CASE SUMMARY: A 42-year-old man with a history of tetralogy of Fallot who underwent atrial septal defect repair and unclogging of the RVOT 10 years ago and pericardiectomy with valvuloplasty 2 years ago for constrictive pericarditis presented with progressive bilateral lower limb pitting edema, along with exertional dyspnea. Transthoracic echocardiography revealed RVOT stenosis, massive PR, and right ventricular dysfunction. Transcatheter pulmonary valve replacement VenusP-Valve significantly improved ventricular function.

DISCUSSION: This case illustrates the efficacy of transcatheter pulmonary valve replacement in the management of RVOT obstruction and PR after complex cardiac surgery.

TAKE-HOME MESSAGES: Benefits of percutaneous pulmonary value reconstruction on severe PR are limited. VenusP-Valve implantation demonstrated superior outcome and was sustained with drastic hemodynamic improvement on a severe PR patient with VenusP-Valve placement.