Overcoming sternal compression: high-risk transcatheter pulmonary valve replacement.

Transcatheter pulmonary valve replacement (TPVR) is often employed for patients who are poor surgical candidates. We present a case of posterior sternal protrusion into a surgically placed right ventricle to pulmonary artery conduit, making the patient a poor candidate for surgical replacement and leading to significant operator distress during ultimately successful TPVR.