Key result
Pre-procedural imaging with balloon interrogation prevents coronary artery compression during interventions across high-risk cases.
Why the study?
Catastrophic coronary artery compression after PPVI in patients with dysfunctional native right ventricular outflow tract post-Tetralogy of Fallot repair is uncommon but poses significant risk.
Case Report (n=3)
Meticulous pre-procedural imaging and balloon interrogation are critical for identifying and mitigating the risk of coronary artery compression during percutaneous pulmonary valve implantation with self-expandable valves.
Multimodal pre-procedural screening may mitigate coronary compression risk during PPVI in rTOF; hypothesis-generating and requires prospective validation.
Catastrophic complications of coronary artery compression after percutaneous pulmonary valve implantation (PPVI) are uncommon in patients with a dysfunctional native right ventricular outflow tract after Tetralogy of Fallot repair (rTOF). Nonetheless, we report three rTOFs with a high risk of compromising coronary blood flow for PPVI. This risk has been elucidated by multimodal assessments, including robust pre-procedural cardiac computed tomography and meticulous balloon interrogation with selective coronary angiography.
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Buntharikpornpun et al. (2026) conducted a case report in Repaired Tetralogy of Fallot (rTOF) (n=3). Percutaneous pulmonary valve implantation (PPVI) was evaluated. Comprehensive pre-procedural imaging and balloon interrogation successfully identified the risk of coronary artery compression in three patients, allowing for safe procedural adaptation or avoidance.
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