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Case Reports: Unusual presentation of more common disease/injury
Pulmonary homograft failure presents as abdominal ascites
  1. Kimberly Renae Ding1,
  2. Jamil Aboulhosn2 and
  3. Priya Pillutla3
  1. 1Internal Medicine, Harbor-UCLA Medical Center, Torrance, California, USA
  2. 2Department of Medicine, Division of Cardiology, Ahmanson/UCLA Adult Congenital Cardiology Center, University of California Los Angeles, Los Angeles, California, USA
  3. 3Department of Medicine, Division of Cardiology, Harbor-UCLA Medical Center, Torrance, California, USA
  1. Correspondence to Dr Kimberly Renae Ding; kding247{at}gmail.com

Abstract

Ascites is a condition typically attributed to liver disease but can be cardiac in aetiology as well. We report of an atypical case of pulmonary homograft failure status—post the Ross-Yacoub procedure as an underlying cause of anasarca. A man in his mid-30s with a history of congenital heart disease presented with abdominal distension and exercise intolerance. His prior history was relevant for congenital bicuspid aortic valve with critical aortic stenosis. Abdomen and pelvis CT revealed a grossly dilated inferior vena cava while transthoracic echocardiogram showed severe homograft pulmonary stenosis and regurgitation. Further investigation with cardiac MRI demonstrated severe pulmonary valve stenosis and regurgitation with significant tricuspid regurgitation and right ventricular dilatation. The transcatheter stent in the right ventricular to pulmonary artery conduit followed by transcatheter valve replacement, which resulted in full resolution of his presenting symptoms.

  • Valvar diseases
  • Heart failure
  • Cardiovascular medicine

https://doi.org/10.1136/bcr-2023-255128

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    Footnotes

    • Twitter @Krenae_d

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: KRD, JA, and PP. The following authors gave final approval of the manuscript: KRD, JA, and PP.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.