Transcatheter pulmonary valve replacement using a Melody valve was successfully performed in a high-risk patient with carcinoid heart disease, resulting in improved haemodynamics.
Case Report (n=1)
Does transcatheter pulmonary valve replacement improve hemodynamics in a high-risk patient with carcinoid heart disease and bioprosthetic pulmonary valve failure?
Transcatheter pulmonary valve replacement is a feasible and effective less-invasive alternative to surgery for high-risk patients with carcinoid heart disease and bioprosthetic pulmonary valve failure.
Abstract Background Carcinoid heart disease (CHD) commonly affects right-sided heart valves, often leading to progressive right heart failure (RHF) and structural valve deterioration. Case Summary A 30-year-old male with CHD and prior bioprosthetic tricuspid and pulmonic valve replacements presented with New York Heart Association Class III symptoms and RHF. Imaging revealed significant degeneration of both valves. Given the high surgical risk (EuroSCORE II 9.12%), the Heart Team opted for transcatheter pulmonary valve replacement (TPVR). Despite challenging anatomy, a Melody valve (Medtronic) was successfully implanted, resulting in improved haemodynamics and no significant residual regurgitation. Discussion Bioprosthetic failure in CHD poses significant treatment challenges. This case underscores the growing role of TPVR as a less invasive and effective alternative to surgery in high-risk patients, with advanced imaging playing a pivotal role in planning and execution.
Antonelli et al. (Wed,) conducted a case report in Carcinoid heart disease (n=1). Transcatheter pulmonary valve replacement (TPVR) with Melody valve was evaluated on Procedural success and haemodynamic improvement. Transcatheter pulmonary valve replacement using a Melody valve was successfully performed in a high-risk patient with carcinoid heart disease, resulting in improved haemodynamics.