Clinical success of re-redo pulmonary valve and pulmonary trunk homograft replacement during the second trimester of pregnancy.

Introduction: Mechanical valve thrombosis in pregnancy is a rare but critical condition requiring precise management.Case Description: This report describes a successful re-redo pulmonary valve and truncus pulmonalis replacement using a homograft in a 30-year-old patient at 18 + 0 weeks gestation. Despite initial management with anticoagulation therapy, no improvement was noted. An interdisciplinary heart team determined that surgical intervention was the only option after the failure of conservative treatment. Pulmonary artery graft with pulmonary valve replacement using homograft was performed successfully using beating-heart technique.Conclusion: Emphasizing a "beating heart" technique and optimized cardiopulmonary bypass (CPB) parameters, this case demonstrates that surgical intervention can serve as an ultima ratio therapy when conservative treatments fail.