Two Melodies in concert: transcatheter double-valve replacement.

Percutaneous pulmonary valve implantation has been established as a valuable treatment option for elder children and adolescents with conduit failure in the right ventricular outflow tract. Transcatheter valve implantation in the tricuspid position is restricted to single case reports. A 26-year-old male initially diagnosed with tetralogy of Fallot and hypoplastic pulmonary arteries hitherto underwent a total of five open chest procedures including tricuspid valve replacement with a bioprosthesis and a pulmonary homograft exchange. He now presented with severe right heart failure due to a degenerated pulmonary homograft and calcified, severely stenotic tricuspid bioprosthesis with markedly dilated and reduced right ventricular function. We report on the first successful percutaneous transcatheter double-valve replacement using two Melody valves in the pulmonary and tricuspid position, respectively.