Parallel Transcatheter Valve and Stent Placement with Subsequent Stent Occlusion to Address a Giant Dysfunctional RVOT in a Patient with Repaired Tetralogy of Fallot.
Eliú David Pérez Nogales, Elisabet Viera Reyes, Sandra Rodríguez Fuster et al.
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Case in brief
A patient with repaired tetralogy of Fallot had right ventricular outflow tract (RVOT) dysfunction with severe pulmonary insufficiency. Surgery was considered unsuitable because of bladder neoplasm, obesity and severe obstructive respiratory disease, while the giant RVOT challenged percutaneous valve options. A 32-mm Myval prosthesis was implanted alongside a vascular stent, which was then occluded with a vascular plug. The report describes this as a palliative approach that improved right ventricular function and reduced symptoms.
What made this case unusual
The giant RVOT was addressed by placing a transcatheter valve and vascular stent in parallel, then occluding the stent with a vascular plug.
Diagnostic / clinical pearl
In a patient with repaired tetralogy of Fallot and a giant dysfunctional RVOT who is unsuitable for surgery, parallel valve and stent placement with subsequent stent occlusion may be a percutaneous palliative option.