Published online Dec 26, 2023. doi: 10.4330/wjc.v15.i12.642
Peer-review started: August 1, 2023
First decision: October 24, 2023
Revised: November 13, 2023
Accepted: December 11, 2023
Article in press: December 11, 2023
Published online: December 26, 2023
Tetralogy of Fallot (TOF) is one of the most common congenital heart defects, and surgery is the primary treatment. There are no precise guidelines on the treatment protocol for tricuspid regurgitation (TR) as a common complication of TOF repair. The timing for treatment in patients presenting with valve regurgitation after TOF repair is often difficult to determine. Here, we report the first case of sequential treatment of pulmonary and TR using interventional therapy.
We present the case of a 52-year-old female patient, who had a history of TOF repair at a young age. A few years later, the patient presented with pulmonary and tricuspid regurgitation. The symptoms persisted and TR worsened following percutaneous pulmonary valve implantation. Preoperative testing revealed that the patient’s disease had advanced to an intermediate to advanced stage and that her general health was precarious. Because open-heart surgery was not an option for the patient, transcatheter tricuspid valve replacement was suggested. This procedure was successful, and the patient recovered fully without any adverse effects. This case report may serve as a useful resource for planning future treatments.
Treatment of both valves should be considered in patients with tricuspid and pulmonary regurgitations following TOF repair. The interventional strategy could be an alternative for patients with poor general health.
Core Tip: Tetralogy of Fallot (TOF) is a common congenital heart disease. Complications following TOF repair, including pulmonary regurgitation, tricuspid regurgitation (TR), and cardiac arrhythmia, can have a negative impact on the prognosis. In this case, the patient had been treated with percutaneous pulmonary valve implantation after TOF repair, but developed TR progression and was treated with transcatheter tricuspid valve replacement. No standardized treatment guidelines for similar patients exist, and the timing and modalities of treatment remain controversial. Therefore, whether patients who develop both types of valve regurgitation after TOF repair should be treated simultaneously or sequentially is important. A treatment plan should be developed based on the patient’s overall condition, with interventional techniques being the optimal option for patients with poor baseline conditions.