Transcatheter pulmonary valve replacement with the venusP-valve system in a patient with double outlet right ventricle and transposition of the great arteries a first-in-human case report.

Abstract

The Taussig-Bing anomaly is a rare form of double outlet right ventricle (DORV) characterized by complex physiology, often requiring multiple surgeries. This report describes the use of the VenusP-Valve System ina 36-year-old patient with Taussig-Bing anomaly, transposition of the great arteries (TGA), and prior surgical interventions including Blalock-Taussig shunt, arterial switch, and ventricular septal defect (VSD) closure. The patient presented with atrial fibrillation, baseline clinical signs of right-sided heart failure (jugular venous distension, edema, holosystolic murmur), New York Heart Association (NYHA) III symptoms, severe tricuspid regurgitation (TR), residual VSD, and significant pulmonary stenosis. Right-heart catheterization revealed an extremely high baseline Qp/Qs of 10.4, derived by the Fick method with oxygen consumption estimation and mixed venous sampling; this value was interpreted as artifact-influenced, and normalized to ∼2 after medical optimization. After multidisciplinary discussion, a transcatheter pulmonary valve replacement (TPVR) using the VenusP-Valve System was successfully performed. At 30 days, the patient improved to NYHA II with no major complications, reduction of TR to moderate, and stable residual VSD shunt (Qp/Qs ∼2). This case highlights the feasibility and clinical utility of VenusP-Valve in managing complex congenital heart disease, particularly in enlarged, irregular, patch-augmented right ventricular outflow tracts (RVOTs) not suitable for balloon-expandable or hourglass-anchoring valves.