The rare congenital anomaly of pulmonary valve stenosis and massive tricuspid valve insufficiency with intact ventricular septum is a lethal condition without reported survival after attempted treatment. In a neonate suffering from this syndrome, the pulmonary valve stenosis was relieved by rupturing the fused valve with a balloon catheter introduced transvenously. The desperate condition of the patient quickly improved after this procedure, with subsequent disappearance of the tricuspid valve incompetence. Balloon rupturing of fused valves at angiography may represent a therapeutic alternative in cases in which surgical valvulotomy is associated with a high mortality.
Clinical balloon debanding of the pulmonary artery is reported in two patients, 6 months and 4 years of age. The band was made of Dacron, and was closed with one single polypropylene suture. This suture was subsequently ruptured with a balloon inflated within the pulmonary artery at the site of the band. Balloon debanding relieved the gradient almost completely in the two patients. No problems occurred during the procedure. In the future this may prove to be an efficient and reliable way to remove the effect of a pulmonary artery banding.
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