Infolding of the Venus P-Valve After Transcatheter Pulmonary Valve Implantation

We report 2 cases of postdeployment infolding of the Venus P-valve after percutaneous pulmonary valve implantation. Both patients had tetralogy of Fallot and underwent surgical repair in childhood comprising transannular patch enlargement of the right ventricular (RV) outflow tract. They developed severe RV dilatation and dysfunction with reduced exercise capacity at ages of 31 and 18 years, respectively. Both were deemed suitable for percutaneous pulmonary valve implantation using the Venus P-valve system (Venus Medtech, Hangzhou, China) via transfemoral venous access. The optimal device diameter was determined by adding 3 to 4 mm to the maximal diameter of the waist of the sizing balloon (Figures 1A and 2A). A detailed description of the landing zone anatomy is provided in the Table. The procedures followed the standard Venus P-valve implantation steps, which have been described in detail previously.1–3 The valve was deployed gradually by opening the distal flare in the distal main pulmonary artery and the proximal flare in the RV outflow tract (Video I and Video IV in the Data Supplement). In both cases, the fully …