Use of lithotripsy (IVL) in severe calcified homograft for optimizing Transcatheter Pulmonary Valve Replacement (TPVR)

Abstract

Severely calcified pulmonary homografts can reduce the chances of successful transcatheter pulmonary valve replacement (TPVR). The use of intravascular lithotripsy (IVL) may improve calcium modification, increase pliability, and enhance valve expansion. Our two cases demonstrated that IVL-facilitated TPVR is both feasible and safe. Intravascular ultrasound (IVUS) and computed tomography (CT) measurements were crucial in determining the appropriate size of the IVL balloon to optimize contact between the calcified homograft and the IVL balloon. Additionally, the application of a G-Armor covered stent can improve sealing and minimize the risk of perforation.