Novel Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm in Repaired Tetralogy of Fallot
- 1Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
- 2Division of Cardiology, Department of Pediatrics, University of Rochester Medicine, Rochester, New York, USA
- 3Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Division of Cardiology, Department of Pediatrics, University of Rochester Medicine, Rochester, New York, USA
Abstract
Background: Ruptured sinus of Valsalva aneurysm (RSVA) following tetralogy of Fallot (TOF) repair is exceedingly rare, with only isolated cases reported. Case Summary: A 53-year-old man with TOF repaired in infancy presented with NYHA functional class IV heart failure. Cardiac computed tomography showed a ruptured right sinus of Valsalva (28.1 × 33.5 mm) draining into the main pulmonary artery. Cardiac catheterization confirmed a left-to-right shunt (pulmonary-to-systemic flow ratio, 2.6:1) with normal pulmonary vascular resistance. Given the prohibitive surgical risk, a 25-mm Harmony pulmonary valve was deployed, achieving complete RSVA occlusion, restoring pulmonary valve competence, and reducing right ventricular pressure. Functional status improved to NYHA functional class II. Discussion: We describe a novel transcatheter approach in repaired TOF, simultaneously addressing RSVA and severe pulmonary regurgitation in a single intervention. Take-Home Messages: RSVA should be suspected in adults with repaired TOF presenting with unexplained heart failure. Transcatheter closure with a Harmony valve may be feasible in carefully selected high-risk surgical candidates with suitable anatomy and concomitant pulmonary valve disease.
Related
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BibTeX
@article{gabrielleaorie2026novel,
title = {{Novel Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm in Repaired Tetralogy of Fallot}},
author = {Gabrielle A. Orie, MS and Karunakar Vadlamudi, MD and Bayan Issa, MD and Joseph D. Kuebler, MD and Glenn T. Leonard, MD},
journal = {JACC: Case Reports},
year = {2026},
month = aug,
doi = {10.1016/j.jaccas.2026.109900},
url = {https://doi.org/10.1016/j.jaccas.2026.109900},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Novel Transcatheter Closure of Ruptured Sinus of Valsalva Aneurysm in Repaired Tetralogy of Fallot
AU - Gabrielle A. Orie, MS
AU - Karunakar Vadlamudi, MD
AU - Bayan Issa, MD
AU - Joseph D. Kuebler, MD
AU - Glenn T. Leonard, MD
PY - 2026
DA - 2026/08/29
JO - JACC: Case Reports
DO - 10.1016/j.jaccas.2026.109900
UR - https://doi.org/10.1016/j.jaccas.2026.109900
AB - Background: Ruptured sinus of Valsalva aneurysm (RSVA) following tetralogy of Fallot (TOF) repair is exceedingly rare, with only isolated cases reported. Case Summary: A 53-year-old man with TOF repaired in infancy presented with NYHA functional class IV heart failure. Cardiac computed tomography showed a ruptured right sinus of Valsalva (28.1 × 33.5 mm) draining into the main pulmonary artery. Cardiac catheterization confirmed a left-to-right shunt (pulmonary-to-systemic flow ratio, 2.6:1) with normal pulmonary vascular resistance. Given the prohibitive surgical risk, a 25-mm Harmony pulmonary valve was deployed, achieving complete RSVA occlusion, restoring pulmonary valve competence, and reducing right ventricular pressure. Functional status improved to NYHA functional class II. Discussion: We describe a novel transcatheter approach in repaired TOF, simultaneously addressing RSVA and severe pulmonary regurgitation in a single intervention. Take-Home Messages: RSVA should be suspected in adults with repaired TOF presenting with unexplained heart failure. Transcatheter closure with a Harmony valve may be feasible in carefully selected high-risk surgical candidates with suitable anatomy and concomitant pulmonary valve disease.
SN - 2666-0849
ER -