Percutaneous Replacement of the Pulmonary Valve in a 12-Year-Old Child
A 12-year-old boy with pulmonary atresia and ventricular septal defect was initially treated with 2 modified Blalock-Taussig shunts. Total repair with closure of the ventricular septal defect and placement of a nonvalved 18-mm conduit from the right ventricle to the pulmonary artery had been performed when he was 5 years old. Seven years later, valvulation of his right ventricular outflow tract was deemed advisable because his clinical status was impaired on exertion and his right ventricle was dilated on echocardiography. Angiography findings before valve replacement are shown in Figure 1 and Movie I. The valve was then percutaneously inserted through the right femoral vein according to standard stent placement. Postprocedural angiography showed perfect functioning of the implanted valve (Figure 2 and Movie II). No significant complications were observed in the early follow-up, and the patient was discharged and given low-dose aspirin the day after the procedure. At 24 months’ follow-up, echocardiography confirmed the competency of the percutaneously implanted valve (Movie III; note the absence of a retrograde flow during diastole).
The online-only Data Supplement, which contains Movies I, II, and III, is available with this article at http://www.circulationaha.org.