Takotsubo cardiomyopathy after transcatheter Edwards Sapien pulmonary valve placement in a patient with tetralogy of Fallot.

A 34-year-old woman who had history of repaired tetralogy of Fallot with absent pulmonary valve syndrome presented for transcatheter intervention to reestablish pulmonary valve competence. A 26-mm Edwards Sapien valve was implanted, and coronary angiography after implantation demonstrated no coronary compression. Hemodynamically stable ventricular tachycardia was documented after the procedure. A 12-lead electrocardiogram showed ST segment elevation, and cardiac enzymes were moderately elevated. An echocardiogram demonstrated the stable position of the new pulmonary valve, the marked circumferential hypokinesia of the mid-to-apical left ventricular myocardium, and the normally contracting basal-to-mid myocardial segments. No intervention was required. An echocardiogram obtained 4 days after discharge showed qualitatively improved left ventricular systolic function, particularly in the apical region.