Early structural valve deterioration of a pulmonary position Inspiris Resilia valve requiring redo pulmonary and tricuspid valve replacement

We report a 50-year-old woman with pulmonary and tricuspid valve regurgitation who required redo pulmonary and tricuspid valve replacement (PVR, TVR). At age 8, she underwent right ventricular outflow tract reconstruction for pulmonary stenosis, and at 44 years she had PVR with a 19 mm Inspiris Resilia bioprosthesis and tricuspid annuloplasty with a 28 mm Physio ring. Three years later, she presented with palpitations and syncope. Echocardiography revealed severe tricuspid regurgitation and moderate pulmonary regurgitation due to dysfunction of a prosthetic leaflet. Redo PVR with a 29 mm Inspiris Resilia valve and TVR with a 27 mm Mitris valve was performed. Early structural valve deterioration of the initial Inspiris prosthesis was suspected. Our experience suggests that using a larger prosthesis may mitigate early degeneration and preserve the option of future transcatheter PVR.