Key result
Individualized, goal-directed anesthetic strategies enabled successful transcatheter pulmonary valve replacement and stable early postoperative recovery in three patients with distinct right-sided hemodynamic patterns.
Why the study?
Anesthetic management for TPVR is challenging due to complex right-sided pathophysiology and variable hemodynamic burden in patients with congenital heart disease.
Case Report (n=3)
No
Individualized, goal-directed anesthetic strategies based on the dominant right-sided hemodynamic abnormality are crucial for successful transcatheter pulmonary valve replacement in patients with congenital heart disease.
Background: Transcatheter pulmonary valve replacement (TPVR) is an established minimally invasive treatment for right ventricular outflow tract dysfunction after repair of congenital heart diseases. However, anesthetic management remains challenging because of complex right-sided pathophysiology and variable hemodynamic burden. Case: We retrospectively reviewed three representative single-center TPVR cases and summarized perioperative anesthetic management and early outcomes. The patients reflected distinct clinical patterns: severe RVOT obstruction with marked right ventricular pressure overload, severe pulmonary regurgitation with right ventricular volume overload, and complex adult congenital heart disease with pulmonary hypertension, atrial fibrillation, and shunt physiology. Despite these differences, anesthetic priorities were similar, including right ventricular protection, control of pulmonary vascular load, stable induction, lung-protective ventilation, close rhythm and hemodynamic monitoring, and preparation for critical procedural events. Conclusions: All three patients underwent TPVR successfully with stable early postoperative recovery, highlighting the importance of individualized but goal-directed anesthetic strategies.
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Zhang et al. (2026) conducted a case report in Right ventricular outflow tract dysfunction after congenital heart disease repair (n=3). Transcatheter pulmonary valve replacement (TPVR) with individualized anesthetic management was evaluated on Successful TPVR and stable early postoperative recovery. Individualized, goal-directed anesthetic strategies enabled successful transcatheter pulmonary valve replacement and stable early postoperative recovery in three patients with distinct right-sided hemodynamic patterns.
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