Hybrid Valve Replacement for Severe Right Ventricular Outflow Tract Dilatation With a Self-Expanding Valve

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BACKGROUND: Right ventricular outflow tract (RVOT) dysfunction as a consequence of conotruncal surgery in congenital heart disease is a common scenario where percutaneous and surgical pulmonary valve replacement (PVR) has been proven as an effective treatment. CASE SUMMARY: Severe dilated RVOT dysfunction due to pulmonary insufficiency was addressed by hybrid pulmonary valve replacement (HPVR). An off-pump RVOT plication was done by sternotomy; thereafter, percutaneous PVR was done. DISCUSSION: Percutaneous PVR has anatomic limitations in complex RVOT dysfunction. Surgical PVR is associated with prolonged hospital stays, need for blood transfusions, inotropic support, and increased risk of ventricular arrhythmias compared with percutaneous PVR. HPVR enables treatment of complex RVOT, reducing surgery morbidity and overcoming the anatomic limitations of percutaneous PVR. To our knowledge, these is the first case published of this autoexpansible valve by HPVR.

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