Percutaneous implantation of a pulmonary valve: an illustrative case

Surgical reconstruction of the right ventricular outflow tract (RVOT) with valved conduits in infants and children with congenital heart disease leads to re-intervention in later life as the ensuing pulmonary regurgitation and stenosis of the degenerating conduit impacts negatively on right ventricular function. Percutaneous pulmonary valve implantation (PPVI) provides a safe alternative to early surgical re-intervention in these patients. We describe this procedure as performed on an 11- year-old boy. Difficulty may be experienced crossing the RVOT prior to PPVI. We describe several techniques that may be used to encourage the distal movement of the delivery system through the RVOT. (Neth Heart J 2007;15:27-30.).