Inferior vena cava balloon-assisted transjugular transcatheter pulmonary valve implantation

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Severe pulmonary regurgitation in repaired tetralogy of Fallot with NYHA class III heart failure and congestive liver cirrhosis (n=1). Intervention: Inferior vena cava balloon-assisted transjugular transcatheter pulmonary valve implantation (22-mm Harmony valve with 20-mm Z-Med II balloon support). Primary outcome: Successful transcatheter pulmonary valve implantation and elimination of pulmonary regurgitation.

Soma Tsuiki; Tomohito Kogure; Motohiro Fujita; Yuki Nakata; Hisao Otsuki; Junichi Yamaguchi

doi:10.1007/s12928-026-01362-3

November 10, 2026Cardiovascular Intervention and TherapeuticsOpen Access

Inferior vena cava balloon-assisted transjugular transcatheter pulmonary valve implantation

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Key result

Temporary IVC balloon occlusion enables successful transjugular Harmony valve implantation to eliminate pulmonary regurgitation.

n=1

Key Points

To report a bailout transjugular transcatheter pulmonary valve implantation technique using inferior vena cava balloon assistance in a patient with severe right heart dilatation.
Evaluated a 66-year-old man with repaired tetralogy of Fallot, NYHA class III heart failure, severe pulmonary regurgitation, and a right ventricular ejection fraction of 25%.
Converted to a right internal jugular vein approach with a 26-Fr sheath after transfemoral failure, though the 25-Fr Harmony delivery system repeatedly prolapsed caudally.
Positioned and transiently inflated a 20-mm Z-Med II balloon via the femoral vein at the right atrium–inferior vena cava junction to redirect the delivery system.
Temporary balloon inflation created a mechanical floor that prevented inferior vena cava prolapse and successfully redirected the delivery catheter toward the right ventricular outflow tract.
A 22-mm Harmony valve was successfully implanted, which eliminated pulmonary regurgitation without causing tricuspid valve injury or worsening tricuspid regurgitation.

Study Design

Type

Case Report (n=1)

Multicenter

No

PICO

P

Population

A 66-year-old man in Japan with repaired tetralogy of Fallot, NYHA class III heart failure, severe pulmonary regurgitation, and an RVEF of 25% undergoing transcatheter pulmonary valve implantation.

I

Intervention / Comparator

Inferior vena cava balloon-assisted transjugular transcatheter pulmonary valve implantation (22-mm Harmony valve with 20-mm Z-Med II balloon support)

O

Primary Outcome

Successful transcatheter pulmonary valve implantation and elimination of pulmonary regurgitation

Limitations

Single patient case report
Lack of long-term follow-up data

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Implication

IVC balloon redirection enabled transjugular Harmony implantation in one case; leaves open feasibility and safety in broader TPVR populations.

Abstract

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Cite This Study

Tsuiki et al. (2026) conducted a case report in Severe pulmonary regurgitation in repaired tetralogy of Fallot with NYHA class III heart failure and congestive liver cirrhosis (n=1). Inferior vena cava balloon-assisted transjugular transcatheter pulmonary valve implantation (22-mm Harmony valve with 20-mm Z-Med II balloon support) was evaluated on Successful transcatheter pulmonary valve implantation and elimination of pulmonary regurgitation.

synapsesocial.com/papers/6af47bd8a6694c5b3e5ed593 https://doi.org/10.1007/s12928-026-01362-3

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Inferior vena cava balloon-assisted transjugular transcatheter pulmonary valve implantation

Key Points

Study Design

PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Inferior vena cava balloon-assisted transjugular transcatheter pulmonary valve implantation

Key Points

Study Design

PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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