Background.

Surgical replacement using bioprostheses is a frequently used strategy to treat right-side heart valves dysfunction in congenital heart disease

Objectives.

The aim of this study was to present the initial experience in Argentina with right-side bioprosthetic valve ring fracture/remodeling and subsequent transcatheter valve-in-valve replacement in patients with congenital heart disease.

Methods.

This was a descriptive and observational study including all patients treated with transcatheter replacement due to bioprosthetic valve dysfunction.

Results.

From August 2021 to May 2023, 5 patients (3 female) with right-side bioprosthetic dysfunction underwent transcatheter intervention as an alternative to de novo surgical replacement. Mean age was 21.2±9.20 years and mean weight 56.2±22.2 kg. Five balloon expandable valves were implanted: 3 in pulmonary position and 2 in tricuspid position, in 4 cases with previous fracture of the valve ring. In all cases, valve function was restored without complications. During follow-up, moderate right valve incompetence was observed in one case.

Conclusion.

Transcatheter “valve-in-valve” replacement in dysfunctional right-side heart bioprostheses is an attractive and safe strategy in selected cases, which restores competence and eliminates obstructions. This approach is a reasonable option as alternative to de novo surgical valve replacement.