Student Scientific Association at Department of Paediatric Cardiology and Congenital Heart Defects, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Department of Paediatric Cardiology and Congenital Heart Defects, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Curie-Sklodowskiej 9 Street, 41-800, Zabrze, Poland.
J Med Case Rep. 2024 Feb 21;18(1):70. doi: 10.1186/s13256-024-04383-9.
Percutaneous pulmonary valve implantation has become an attractive method of dysfunctional right ventricle outflow tract treatment.
We describe a unique case of a 20-year-old Caucasian male patient with a complex cyanotic heart defect, namely pulmonary atresia, with congenitally corrected transposition of the great arteries and ventricular septal defect after Rastelli-like surgery at the age of 5 years with homograft use. At the age of 20 years, the patient needed percutaneous pulmonary valve implantation owing to homograft dysfunction. Despite unusual course of the coronary arteries, balloon testing in the landing zone of the right ventricle outflow tract excluded potential coronary artery compression. Then, after presentation, a Melody valve was implanted successfully in the pulmonary valve position. The 8-year follow-up was uneventful.
This is likely the first description of a percutaneous pulmonary valve implantation in such anatomy. Such a procedure is feasible; however, it requires exceptional caution owing to the anomalous coronary arteries course, which can be the reason for their compression.
经皮肺动脉瓣植入术已成为治疗功能障碍右心室流出道的一种有吸引力的方法。
我们描述了一个独特的病例，一名 20 岁的白人男性患者患有复杂的发绀性心脏缺陷，即肺动脉闭锁，伴有先天性矫正性大动脉转位和室间隔缺损，曾在 5 岁时接受过类似于 Rastelli 的手术，并使用同种异体移植物。20 岁时，由于同种异体移植物功能障碍，患者需要进行经皮肺动脉瓣植入术。尽管冠状动脉的走行异常，但在右心室流出道着陆区的球囊测试排除了潜在的冠状动脉压迫。随后，在出现症状后，成功地在肺动脉瓣位置植入了一枚 Melody 瓣膜。8 年的随访无不良事件。
这可能是首例在这种解剖结构下进行经皮肺动脉瓣植入术的描述。该手术是可行的；然而，由于异常的冠状动脉走行，需要特别小心，因为这可能是导致其受压的原因。
