Transcatheter Pulmonary Valve Replacement in an Extra-Large RVOT Using a Custom-Made Pulmonary Valve
Issued Date
2025-01-01
Resource Type
eISSN
26660849
Scopus ID
2-s2.0-105022196172
Journal Title
Jacc Case Reports
Rights Holder(s)
SCOPUS
Bibliographic Citation
Jacc Case Reports (2025)
Suggested Citation
Plearntummakun P., Durongpisitkul K., Chungsomprasong P., Vijarnsorn C., Chanthong P., Soongswang J., Panjasamanvong P., Tocharoenchok T., Slisatkorn W., Sriyoschati S. Transcatheter Pulmonary Valve Replacement in an Extra-Large RVOT Using a Custom-Made Pulmonary Valve. Jacc Case Reports (2025). doi:10.1016/j.jaccas.2025.106035 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113234
Title
Transcatheter Pulmonary Valve Replacement in an Extra-Large RVOT Using a Custom-Made Pulmonary Valve
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Transcatheter pulmonary valve replacement (TPVR) offers a less invasive alternative to surgical pulmonary valve replacement in patients with severe pulmonary regurgitation after tetralogy of Fallot repair. However, a complex right ventricular outflow tract (RVOT) anatomy can prevent the use of conventional TPVR devices. Case Summary: We report a patient with tetralogy of Fallot and a hypoplastic left pulmonary artery who had undergone transannular patch repair and developed severe pulmonary regurgitation. Imaging revealed an excessively dilated, aneurysmal RVOT, precluding the use of available TPVR systems. Discussion: A customized self-expandable endovascular graft system was created by incorporating a tailored pulmonary valve with fenestration for the left pulmonary artery. Preprocedural planning used multimodality imaging and three-dimensional printing for simulation. This is to our knowledge the first report of a patient-specific, custom-made TPVR system successfully used in a patient with a large, complex RVOT. Take-Home Messages: Careful assessments of RVOT morphology, branch pulmonary artery anatomy, and coronary relationships are essential for planning. This approach expands treatment options for anatomies unsuitable for standard TPVR devices.