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Hybrid approach to transcatheter pulmonary valve replacement in patients with excessively large anatomy

Published online by Cambridge University Press:  30 May 2025

Qiao Li*
Affiliation:
Department of Cardiovascular Medicine, West China Hospital, Sichuan University, Chengdu, China
Yunfei Ling
Affiliation:
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
Changping Gan
Affiliation:
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China
Yuan Feng
Affiliation:
Department of Cardiovascular Medicine, West China Hospital, Sichuan University, Chengdu, China
Zhengang Zhao
Affiliation:
Department of Cardiovascular Medicine, West China Hospital, Sichuan University, Chengdu, China
*
Corresponding author: Qiao Li; Email: lynchlee007@163.com

Abstract

After right ventricular outflow tract obstruction reconstruction for CHD, surgical pulmonary valve replacement, or transcatheter pulmonary valve replacement may be performed if complicated by moderately severe or severe right ventricular outflow tract dysfunction. However, for patients whose anatomy is not suitable for transcatheter pulmonary valve replacement, surgical pulmonary valve replacement is the only option, but it has a higher rate of perioperative complications and longer hospitalisation for patients. In two cases of severe transcatheter pulmonary valve replacement in which percutaneous pulmonary valve implantation could not be performed directly due to the presence of a large right ventricle, a significant decrease in right ventricular function, and significant widening of the pulmonary arteries, we used a new hybridisation procedure to partially fold and reduce the diameter of the significantly widened pulmonary artery trunk without cardiopulmonary bypass by surgically opening the thorax in a median way, and then successfully implanted a percutaneous self-expanding pulmonary valve valve, with good immediate results in the postoperative period. The postoperative recovery was rapid and the recent results were excellent.

Type
Case Report
Copyright
© The Author(s), 2025. Published by Cambridge University Press

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Footnotes

Changping Gan, Yuan Feng and Zhengang Zhao have equal contributions and are the co-corresponding authors of this work.

References

Chaturvedi, RR, Redington, AN. Pulmonary regurgitation in congenital heart disease. Heart 2007; 93: 880889.10.1136/hrt.2005.075234CrossRefGoogle ScholarPubMed
Kaza, AK, et al. Long-term results of right ventricular outflow tract reconstruction in neonatal cardiac surgery: options and outcomes. J Thorac Cardiovasc Surg 2009; 138: 911916.10.1016/j.jtcvs.2008.10.058CrossRefGoogle ScholarPubMed
Gatzoulis, MA, et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet 2000; 356 975981.10.1016/S0140-6736(00)02714-8CrossRefGoogle ScholarPubMed
Murphy, JG, et al. Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med 1993; 329: 593599.10.1056/NEJM199308263290901CrossRefGoogle ScholarPubMed
Stout, KK, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019; 73: e81e192.10.1016/j.jacc.2018.08.1029CrossRefGoogle Scholar
Otto, CM, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 143: e35e71.10.1161/CIR.0000000000000932CrossRefGoogle Scholar
Ribeiro, JM, et al. Transcatheter versus surgical pulmonary valve replacement: a systemic review and meta-analysis. Ann Thorac Surg 2020; 110: 17511761.10.1016/j.athoracsur.2020.03.007CrossRefGoogle ScholarPubMed
Baumgartner, H, et al. 2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J 2021; 42: 563645.10.1093/eurheartj/ehaa554CrossRefGoogle ScholarPubMed
Schievano, S, et al. Variations in right ventricular outflow tract morphology following repair of congenital heart disease: implications for percutaneous pulmonary valve implantation. J Cardiovasc Magn Reson 2007; 9: 687695.10.1080/10976640601187596CrossRefGoogle ScholarPubMed
Morgan, G, et al. Medium-term results of percutaneous pulmonary valve implantation using the venus P-valve: international experience. EuroIntervention 2019; 14: 13631370.10.4244/EIJ-D-18-00299CrossRefGoogle ScholarPubMed
Karima Addetia, GMAD. Abstract 9635: percutaneous vs. srugical pulmonary valve implantation: how does the right ventricle fare?[J]. Circulation 2012; 126(Issue suppl_21). A9635.Google Scholar
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