Hybrid Transcatheter Pulmonary Valve Replacement With SAPIEN S3 Following Right Ventricular Outflow Tract Reduction Using Tricuspid Annuloplasty Rings

We describe a novel variation of hybrid TPVR using a tricuspid annuloplasty ring which can be considered for patients with very large RVOT, short pulmonary artery, and limited vascular access and to avoid the risk of cardiopulmonary bypass. The utilization of Carpentier-Edwards Physio Tricuspid annuloplasty ring can reduce the size of the RVOT and at the same time the ring served as an effective docking site for the implantation of the SAPIEN S3 (Edwards Lifesciences). All three reported cases showed satisfactory immediate hemodynamic and clinical outcomes as well as at mid-term follow up.