Acute left ventricular systolic dysfunction after percutaneous self-expanding pulmonary valve implantation in a 14-year-old boy

More than half of patients who have previously undergone surgical repair of tetralogy of Fallot develop right ventricular outflow tract dysfunction at some stage during lifetime.After transannular patch repair or implantation of a conduit connecting right ventricle (RV) to the pulmonary artery, progressive development of regurgitation, conduit stenosis or a combination of both is observed over time.Sustained pulmonary regurgitation leads to RV volume overload, progressive ventricular dilation and dysfunction.These pathophysiological alterations are associated with an elevated risk of life-threatening arrhythmias, development of heart failure, and increased mortality.A recognized therapeutic approach for managing right ventricular outflow tract dysfunction is percutaneous pulmonary valve implantation (PPVI) [1,2].The valves most frequently utilized in the aforementioned procedure comprise, among others, the Melody (Medtronic, Minneapolis, MN, US), Sapien (Edwards, Irvine, CA, US), Pulsta