METHODS: 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.
CONCLUSIONS: 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.
方法:我们描述了一个20岁的白种人男性患者的独特病例,患有复杂的紫红色心脏缺陷,即肺动脉闭锁,在5岁的使用同种异体移植的Rastelli样手术后,先天性纠正了大动脉移位和室间隔缺损。在20岁的时候,由于同种异体移植功能障碍,患者需要经皮肺动脉瓣植入术。尽管冠状动脉异常,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。然后,介绍后,a旋律瓣膜成功植入肺动脉瓣位置。8年的随访是顺利的。
结论:这可能是对这种解剖结构的经皮肺动脉瓣植入的首次描述。这样的程序是可行的;然而,由于冠状动脉异常,它需要格外小心,这可能是他们压缩的原因。