# Beating-Heart Pulmonary Valve Replacement for Isolated Monocuspid Valve

## TL;DR

This paper presents a rare case of a 20-year-old woman with an isolated monocuspid pulmonary valve who successfully underwent a novel beating-heart surgical procedure.

## Contribution

The paper introduces beating-heart pulmonary valve replacement as a novel and less invasive surgical approach.

## Key findings

- The beating-heart technique was successfully used for pulmonary valve replacement and aneurysm repair.
- Isolated monocuspid pulmonary valve can lead to severe right ventricular dilation and aneurysmal dilation.

## Abstract

A monocuspid pulmonary valve is a rare cardiac anomaly that is most commonly seen in patients with other congenital heart defects. Its isolated occurrence is extremely rare.

A 20-year-old woman with a history of congenital heart disease presented with exertional dyspnea and generalized weakness. Imaging revealed severe right ventricular dilation and significant enlargement of the main pulmonary artery. Owing to the high risk of aneurysm rupture, she underwent aneurysmectomy, aneurysmorrhaphy, and pulmonary valve replacement (PVR). The heart was maintained in a beating state throughout the procedure, including during cardiopulmonary bypass without cardioplegic arrest.

This case demonstrates the feasibility of performing PVR and aneurysm repair using the beating-heart technique.

Monocuspid pulmonary valve can occur in isolation and may cause progressive pulmonary valve insufficiency and aneurysmal dilation. Beating-heart PVR is a novel and less invasive surgical approach compared with traditional methods.