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Published online by Cambridge University Press: 13 May 2025
This report describes a 41-year-old female with left isomerism, interrupted inferior caval vein with azygos continuation, dextrocardia, and repaired tetralogy of Fallot, who underwent percutaneous pulmonary valve implantation using the Venus P-valve system. Due to anatomical constraints, left jugular venous access was utilised. A Venus P-valve (30 by 25 mm) was successfully implanted in the right ventricular outflow tract using a simplified, one-curve trajectory directly on its delivery system without a delivery sheath. Contrast injections during valve implantation were not possible, and the pre-implanted duct occluder was our anatomical landmarks. This case highlights the adaptability of the Venus P-valve and the importance of individualised procedural strategies in addressing anatomical challenges and achieving optimal outcomes.