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(Circulation. 2004;110:e516.)
© 2004 American Heart Association, Inc.

Images in Cardiovascular Medicine

Percutaneous Replacement of the Pulmonary Valve in a 12-Year-Old Child

Younes Boudjemline, MD; Sachin Khambadkone, MD; Damien Bonnet, MD; Graham Derrick, MD; Gabriella Agnoletti, MD; John Deanfield, MD; Daniel Sidi, MD; Philipp Bonhoeffer, MD

From the Service de Cardiologie Pédiatrique, Hôpital Necker-Enfants-Malades, Paris, France (Y.B., D.B., G.A., D.S.) and the Cardiothoracic Unit, Great Ormond Street Hospital for Children NHS Trust, London, England (S.K., G.D., J.D., P.B.).

Correspondence to Dr Younes Boudjemline, Hôpital Necker-Enfants-Malades, 149 rue de Sèvres, 75015 Paris, France. E-mail younes.boudjemline{at}nck.ap-hop-paris.fr

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).

View larger version (95K): [in this window] [in a new window]   Figure 1. Pulmonary angiogram before valve replacement. Four-chamber (A) and lateral (B; see also Movie I) views. Note the opacification of the right ventricle resulting from the pulmonary leak.

View larger version (97K): [in this window] [in a new window]   Figure 2. Pulmonary angiogram after valve replacement. Four-chamber (A) and lateral (B; see also Movie II) views. Note that the contrast does not regurgitate in the right ventricle, confirming the perfect functioning of the newly implanted valve.

Footnotes

The online-only Data Supplement, which contains Movies I, II, and III, is available with this article at http://www.circulationaha.org.

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This Article Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Boudjemline, Y. Articles by Bonhoeffer, P. Search for Related Content PubMed PubMed Citation Articles by Boudjemline, Y. Articles by Bonhoeffer, P. Related Collections Catheter-based coronary and valvular interventions: other Related Article