{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T06:22:42Z","timestamp":1787638962421,"version":"build-2736575974"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transcatheter pulmonary valve replacement (TPVR) is an established minimally invasive treatment for right ventricular outflow tract dysfunction after repair of congenital heart diseases. However, anesthetic management remains challenging because of complex right-sided pathophysiology and variable hemodynamic burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>We retrospectively reviewed three representative single-center TPVR cases and summarized perioperative anesthetic management and early outcomes. The patients reflected distinct clinical patterns: severe RVOT obstruction with marked right ventricular pressure overload, severe pulmonary regurgitation with right ventricular volume overload, and complex adult congenital heart disease with pulmonary hypertension, atrial fibrillation, and shunt physiology. Despite these differences, anesthetic priorities were similar, including right ventricular protection, control of pulmonary vascular load, stable induction, lung-protective ventilation, close rhythm and hemodynamic monitoring, and preparation for critical procedural events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All three patients underwent TPVR successfully with stable early postoperative recovery, highlighting the importance of individualized but goal-directed anesthetic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1866846","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:35:24Z","timestamp":1787636124000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Teaching points in anesthetic management for transcatheter pulmonary valve replacement: a case series"],"prefix":"10.3389","volume":"13","author":[{"given":"Meng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Sichuan Provincial People\u2019s Hospital, University of Electronic Science and Technology of China","place":["Chengdu, Sichuan, China"]},{"name":"Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University","place":["Luzhou, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyuan","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Baylor College of Medicine","place":["Houston, TX, United States"]},{"name":"Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine","place":["Bronx, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Sichuan Provincial People\u2019s Hospital, University of Electronic Science and Technology of China","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biology, Duke University","place":["Durham, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Sichuan Provincial People\u2019s Hospital, University of Electronic Science and Technology of China","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Sichuan Provincial People\u2019s Hospital, University of Electronic Science and Technology of China","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"14","DOI":"10.37616\/2212-5043.1448","article-title":"Transcatheter pulmonary valve replacement (TPVR): a Saudi consensus statement","volume":"37","author":"AlNajashi","year":"2025","journal-title":"J Saudi Heart Assoc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1016\/j.athoracsur.2020.03.007","article-title":"Transcatheter versus surgical pulmonary valve replacement: a systemic review and metaanalysis.. (2020) 110(5):\u201361. doi:","volume":"110","author":"Ribeiro","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"5343","DOI":"10.21037\/jtd.2019.11.64","article-title":"Clinical outcomes of transcatheter versus surgical pulmonary valve replacement: a meta-analysis","volume":"11","author":"Zhou","year":"2019","journal-title":"J Thorac Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"213","DOI":"10.3390\/jcm15010213","article-title":"Transcatheter pulmonary valve outcomes and mechanisms of dysfunction","volume":"15","author":"Matoq","year":"2025","journal-title":"J Clin Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s40119-012-0005-9","article-title":"Transcatheter pulmonary valve replacement","volume":"1","author":"Ghawi","year":"2012","journal-title":"Cardiol Ther"},{"key":"B6","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1002\/ped4.12359","article-title":"Transcatheter pulmonary valve replacement in congenital heart diseases","volume":"6","author":"Chau","year":"2022","journal-title":"Pediatr Investig"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.1016\/j.jacc.2016.07.734","article-title":"Transcatheter pulmonary valve replacement reduces tricuspid regurgitation in patients with right ventricular volume\/pressure overload","volume":"68","author":"Jones","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.3390\/bioengineering10101136","article-title":"Treatment of severe pulmonary regurgitation in enlarged native right ventricular outflow tracts: transcatheter pulmonary valve replacement with three-dimensional printing guidance","volume":"10","author":"Wang","year":"2023","journal-title":"Bioengineering (Basel)"},{"key":"B9","doi-asserted-by":"publisher","first-page":"658","DOI":"10.21037\/acs-2021-tviv-28","article-title":"Transcatheter pulmonic valve implantation in adult patients with prior congenital heart surgery","volume":"10","author":"Spigel","year":"2021","journal-title":"Ann Cardiothorac Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/j.amjcard.2019.06.030","article-title":"Atrial septal defect and the risk of ischemic stroke in the perioperative period of noncardiac surgery","volume":"124","author":"Smilowitz","year":"2019","journal-title":"Am J Cardiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/S0002-9149(01)02160-9","article-title":"Predisposing conditions for atrial fibrillation in atrial septal defect with and without operative closure","volume":"89","author":"Mar\u00eda Oliver","year":"2002","journal-title":"Am J Cardiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1093\/ejcts\/ezs221","article-title":"Preservation of right ventricular structure and function following transatrial-transpulmonary repair of tetralogy of fallot","volume":"43","author":"Sfyridis","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.jcin.2014.02.006","article-title":"Effects of transcatheter pulmonary valve replacement on the hemodynamic and ventricular response to exercise in patients with obstructed right ventricle-to-pulmonary artery conduits","volume":"7","author":"Hasan","year":"2014","journal-title":"JACC Cardiovasc Interv"},{"key":"B14","doi-asserted-by":"publisher","first-page":"ytab301","DOI":"10.1093\/ehjcr\/ytab301","article-title":"Case report: successful emergent transcatheter pulmonary valve replacement within failing pulmonary artery conduit in the setting of cardiogenic shock with extracorporeal membrane oxygenation support","volume":"5","author":"Sabbak","year":"2021","journal-title":"Eur Heart J Case Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2724","DOI":"10.1002\/ccd.70129","article-title":"Characterizing the acute changes in pulmonary capillary wedge pressure associated with transcatheter pulmonary valve replacement","volume":"106","author":"Vargas-Acevedo","year":"2025","journal-title":"Catheter Cardiovasc Interv"},{"key":"B16","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1148\/rg.210160","article-title":"Pre- and postprocedure imaging of transcatheter pulmonary valve implantation","volume":"42","author":"Canan","year":"2022","journal-title":"Radiographics"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1016\/j.jcin.2020.03.035","article-title":"Outcomes after transcatheter reintervention for dysfunction of a previously implanted transcatheter pulmonary valve","volume":"13","author":"Shahanavaz","year":"2020","journal-title":"JACC Cardiovasc Interv"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1866846\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:35:25Z","timestamp":1787636125000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1866846\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":17,"alternative-id":["10.3389\/fcvm.2026.1866846"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1866846","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"article-number":"1866846"}}