2024 Volume 28 Issue 1 Pages 119-123
Significant pulmonary valve regurgitation after congenital heart disease surgery in adults is being observed increasingly. Since 2010, transcatheter pulmonary valve implantation (TPVI) is being performed in the United States in patients with a history of multiple operations, who are considered at high risk for open heart surgery. The Harmony? Transcatheter Pulmonary Valve System (Medtronic Japan, Inc., [Harmony TPV]) was introduced into clinical practice in Japan in March 2023. It is a transcatheter implantation system that uses a porcine pericardial bioprosthetic valve attached to a self-expandable nitinol frame. Transcatheter implantation of the device is performed using a biplane X-ray angiography system. Although TPVI is minimally invasive, the caveats associated with this approach include the need for nonoperating room anesthesia management, complications attributable to poor surgical skill, procedure-related arrhythmias, and circulatory instability during valve deployment.
In this report, we describe our experience with anesthesia management in two cases of TPVI.
