Beating-Heart Pulmonary Valve Replacement for Isolated Monocuspid Valve.

BACKGROUND

A monocuspid pulmonary valve is a rare cardiac anomaly that is most commonly seen in patients with other congenital heart defects. Its isolated occurrence is extremely rare.

CASE SUMMARY: A 20-year-old woman with a history of congenital heart disease presented with exertional dyspnea and generalized weakness. Imaging revealed severe right ventricular dilation and significant enlargement of the main pulmonary artery. Owing to the high risk of aneurysm rupture, she underwent aneurysmectomy, aneurysmorrhaphy, and pulmonary valve replacement (PVR). The heart was maintained in a beating state throughout the procedure, including during cardiopulmonary bypass without cardioplegic arrest.

DISCUSSION: This case demonstrates the feasibility of performing PVR and aneurysm repair using the beating-heart technique.

CONCLUSIONS

Monocuspid pulmonary valve can occur in isolation and may cause progressive pulmonary valve insufficiency and aneurysmal dilation. Beating-heart PVR is a novel and less invasive surgical approach compared with traditional methods.