Transcatheter Implantation of Balloon-Expandable Valve in a Repaired Native Tricuspid Valve Without Annuloplasty Ring

Late complications of repaired congenital heart disease are increasingly common, including tricuspid stenosis and regurgitation. We present a case of a 36-year-old female with tetralogy of Fallot, 1.5 ventricle repair, and prior tricuspid repair using homograft tissue without an annuloplasty ring, who developed worsening congestive heart failure. Transesophageal echocardiogram revealed severe tricuspid stenosis and regurgitation. We performed transcatheter tricuspid valve replacement with a SAPIEN S3 Ultra RESILIA valve within a CP-covered stent. To our knowledge, this is the first implantation of the SAPIEN S3 Ultra RESILIA valve in the tricuspid position without an annuloplasty ring, and the first implantation of a balloon-expandable valve in a native tricuspid valve without extracorporeal membrane oxygenation support.