[Modified technique for dilatation of pulmonary valve stenosis (nearly atresia) in a neonate]

A modified technique for pulmonary valvuloplasty is described in a 1-day-old newborn with near pulmonary atresia. A transumbilical venous approach and a complete set of devices for coronary angioplasty were utilized; the principal technical innovation was the use of a 7 French right coronary artery guiding catheter. This allowed a firm support to advance the first balloon catheter (a 3.5 coronary angioplasty catheter) through the pulmonary valve, maintaining the guidewire in a stable position in the descending aorta. The dilation was easily completed with progressively larger balloons. The total procedure time was 82' (fluroscopy time 20'), significantly shorter than the previous personal experience and the data from the literature.