Percutaneous pulmonary valve implantation in a single artery branch: A preliminary experience

Figure 1 Angiograms in anterior-posterior, LL, right anterior oblique projections of the percutaneous pulmonary valve implantation using a Melody valve. A-C: Injections in the RV and origin of the RPA showing a dilated RVOT and stenosis at the origin of the RPA; D: Evidence at the balloon sizing of a waist at the origin of the RPA; E: Pre-stenting of the PA branch with a 43 mm ANDRA XXL; F: Good final result after Valve implantation with no evidence of PVR. PPVI: Percutaneous pulmonary valve implantation; RVOT: Right ventricular outflow tract; PA: Pulmonary arteries; RPA: Right pulmonary artery; AP: Anterior-posterior.

Figure 2 Angiograms in anterior-posterior, LL, projections of the percutaneous pulmonary valve implantation using a Sapien valve. A, B: Injections in the RV showing a dilated and calcified conduit with some degree of stenosis at the PA edge; C: A compliant AGA 34 mm ASD sizing balloon was inserted into the Freestyle conduit showing the stenotic area; D: Prestenting of the conduit using a premounted covered CP stent 45 mm; E: Second covered CP stent was implantation; F: After a re-dilation by utilizing an ATLAS 22 × 40 balloon dilatated at 14 Atm a final stented conduit was obtained with a proximal angle nor suitable for a PPVI in a regular position. PPVI: Percutaneous pulmonary valve implantation; RV: Right ventricular; PA: Pulmonary arteries.