Implantation of A Myval Octacor Aortic Valve in the Pulmonary Position Secondary to Combined Pulmonary Valve Disease Due to Severe Subvalvular Stenosis and Moderate Regurgitation: Case Report

Pulmonary stenosis is a congenital heart disease that may occur in isolation or in association with conditions such as Tetralogy of Fallot and Noonan Syndrome. It may be located at the valvular, subvalvular, or supravalvular level and is classified as mild, moderate, or severe according to the obstructive gradient. As the disease progresses, it may lead to right ventricular failure, dyspnea, syncope, and systemic congestion. Pulmonary regurgitation is usually secondary to pulmonary hypertension or surgically corrected congenital heart diseases, resulting in volume overload and deterioration of right ventricular function. Diagnosis is primarily established by echocardiography, complemented by cardiac magnetic resonance imaging and cardiac computed tomography. Percutaneous treatment with transcatheter valves, such as Melody, Harmony, and Edwards SAPIEN, has demonstrated improvement in symptoms, reduction of pulmonary regurgitation, and preservation of right ventricular function, although appropriate anatomical selection is required due to the risk of complications.