Vector Flow Mapping for Hemodynamic Assessment Before and After Percutaneous Pulmonary Valve Implantation: A Case Report
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Background Severe pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair leads to right ventricular (RV) dilation and dysfunction. Early postoperative assessment after percutaneous pulmonary valve implantation (PPVI) may be insufficient using conventional echocardiographic indices. Case presentation: A 10-year-old girl with repaired TOF presented with severe PR and RV dilation. Vector flow mapping (VFM) was used before and after PPVI to assess RV and right ventricular outflow tract–pulmonary artery (RVOT–PA) flow fields. Pre-procedural VFM revealed abnormal RV vortices, elevated diastolic energy loss (EL), and pronounced reverse flow in RVOT–PA. Immediately after PPVI, RV flow normalized, reverse flow disappeared, and EL decreased markedly, despite minimal early improvement in standard RV functional indices. Conclusions VFM sensitively demonstrated early hemodynamic improvement after PPVI, offering additional value beyond conventional echocardiographic indices. Flow-field–based metrics may aid postoperative assessment in congenital heart disease.
