Aortic Sinus–to–RVOT Communication Following Harmony Valve Implantation

The use of self-expanding valve platforms in the setting of regurgitant native right ventricular outflow tracts is progressing rapidly, promising the potential of lifetime percutaneous therapy for some patients who previously had been committed to sternotomy with cardiopulmonary bypass surgery. These developments have been associated with some unpredicted complications whose aetiologies are now starting to develop into patterns which may be related to valve design as well as specific patient anatomic substrates. We report the case of an iatrogenic communication from the RVOT into the right coronary sinus by a Harmony valve in a patient whose original diagnosis was pulmonary stenosis with a small ventricular septal defect.