eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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Sarajevo Declaration on Integrity and Visibility of Scholarly Publications
4/2011
vol. 7
 
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abstract:

Case report
Is the “porcellain homograft” a contraindication for transcatheter pulmonary valve implantation? A case report

Marcin Demkow
,
Witold Rużyłło
,
Elżbieta K. Biernacka
,
Jacek Różański
,
Mariusz Kuśmierczyk

Post Kardiol Interw 2011; 7, 4 (26): 323–326
DOI: https://doi.org/10.5114/pwki.2011.25794
Online publish date: 2011/11/25
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A male patient had a repeat surgical right ventricular outflow reconstruction with the aortic homograft, for pulmonary atresia at the age of 7 years. At the age of 17 a homograft dysfunction (with predominant stenosis) developed and he was admitted for transcatheter pulmonary valve implantation. Severe calcifications of the total homograft wall were recognized. A homograft rupture with contrast extravasation to the mediastinal space occurred at the superior margin of the stent implanted for valve presenting. A covered stent was implanted to cover the leak, but this resulted in a second homograft rupture at the distal margin of the stent. The extravasation was estimated to be small and stable, and a Melody pulmonary valve was successfully implanted on a 20 mm system. Repeat planned angiography 4 days after the procedure revealed significant enlargement of the pseudoaneurysm and the patient was sent for surgery. Right ventricular outflow was uneventfully reconstructed with a pulmonary homograft. Excised old aortic homograft walls had an eggshell appearance. We suggest that a “porcelain” aortic homograft should be a contraindication for transcatheter pulmonary valve implantation.
keywords:

transcatheter valve implantation pulmonary valve, pulmonary, aortic homograft, homograft rupture
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