C15 PERCUTANEOUS EDGE–TO–EDGE REPAIR USING EDWARDS PASCAL SYSTEM FOR SEVERE TRICUSPID REGURGITATION IN CONGENITALLY CORRECTED TRANSPOSITION OF THE GREAT ARTERIES

Abstract Introduction Congenitally corrected transposition of the great arteries (ccTGA) is a rare cardiac malformation characterized by ‘double’ discordance atrioventricular and ventriculo–arterial connections, resulting in systemic tricuspid valve right ventricle. Clinical case We describe report 54 years–old male patient with ccTGA, diagnosed when he was 3 years–old. Patient performed regular follow–up. Since December 2019, reported onset effort dyspnoea (NYHA III), fatigue exercise intolerance. Despite medication optimization, his symptoms persisted. He referred at our Centre for specialist evaluation. Transthoracic echocardiography showed mild dilatation dysfunction ventricle, massive regurgitation (EROA 42 mm2), due to multiple jets systolic pulmonary artery pressure 45 mmHg. As most recent guidelines, indication given surgical replacement valve. However, refused surgery option. Transesophageal (TEE) screening feasibility percutaneous approach regurgitation. Being jet central, strategy place one device implant between septal anterior leaflet (9–3 oriented), as central possible. Following simultaneous capture further optimization leaflet, result excellent. Post–implant deployment TEE revealed only mild–to–moderate residual regurgitation, no stenosis (mean gradient 2 mm Hg). The bicuspidization recovered quickly discharged home days after procedure. experienced significant improvement functional status I), capacity quality life 6 months Conclusions In ccTGA patients, treatment severe ventricle’s function critical since progression RV are considered key determinants morbidity mortality these patients. Based on results obtained case, edge–to edge repair seems be reasonable alternative three–dimensional transesophageal imperative proper visualization leaflets outcome procedure durability.