Surgical re-utilization of a pulmonary valve graft after failed percutaneous treatment

The case is reported of a 22-year-old woman with severe right ventricular outflow tract (RVOT) homograft regurgitation and stenosis, after the repair of tetralogy of Fallot and complete atrioventricular canal, who was scheduled for percutaneous pulmonary valve implantation. In the catheterization laboratory, immediately after implantation, the stented pulmonary valve became dislodged back into the right ventricle. The patient required an emergency re-sternotomy in the operating room. When the RVOT had been incised the stented valve was rescued and successfully repositioned under direct surgical vision. The patient had an uneventful clinical outcome and was discharged home in good clinical condition, with a new, well-functioning pulmonary valve.