We report the case of a 14-year-old boy affected by Tetralogy of Fallot and pulmonary atresia, who had already undergone multiple surgical procedures. He had later developed a steno-insufficiency of the pulmonary bioprosthesis. We performed a percutaneous pulmonary valve implantation (PPVI), which is a minimally invasive treatment, as effective as conventional valve surgery and associated with less morbidity and mortality. Up to now PPVI has been carried out in patients with chronic pulmonary vascular resistance (PVR) in the presence of a right ventricular outflow tract (RVOT) patch by prior deployment of an intravascular stent as an artificial conduit that makes subsequent valve implantation possible. The peculiarity of our procedure was that we implanted the valve directly on to the annulus of the bioprosthesis (valve-in-valve), without performing a prestenting of the prosthetic valve.
aPediatric Cardiology, Azienda Policlinico - Ospedale Pediatrico Giovanni XXIII, Bari, Italy
bInterventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy
Correspondence to Maristella Lombardi, MD, Azienda Policlinico-Ospedale Pediatrico Giovanni XXIII, Bari, Italy Tel: +39 0805596698; fax: +39 0805596835; e-mail: marilombardi@E-Mail.com
Received 30 October, 2011
Revised 31 December, 2011
Accepted 7 February, 2012